Usefulness of sennoside as an agent for mechanical bowel preparation prior to elective colon cancer surgery

• Published in: Asian journal of surgery Vol. 35; no. 2; pp. 81 - 87
• Main Authors: Ishibashi, Keiichiro, Kumamoto, Kensuke, Kuwabara, Kouki, Hokama, Naoko, Ishiguro, Toru, Ohsawa, Tomonori, Okada, Norimichi, Miyazaki, Tatsuya, Yokoyama, Masaru, Tsuji, Yoshitaka, Haga, Norihiro, Ishida, Hideyuki
• Format: Journal Article
• Language: English
• Published: China Elsevier B.V 01.04.2012; Elsevier
• Subjects: Adult; Aged; Aged, 80 and over; Anthraquinones - administration & dosage; Anti-Bacterial Agents - therapeutic use; Antibiotic Prophylaxis; bowel preparation; Cathartics - administration & dosage; Cefmetazole - therapeutic use; colon cancer; Colonic Neoplasms - surgery; Drug Administration Schedule; Drug Therapy, Combination; Erythromycin - therapeutic use; Female; Humans; Incidence; Kanamycin - therapeutic use; Logistic Models; Male; Middle Aged; Multivariate Analysis; Preoperative Care - methods; Retrospective Studies; Senna Extract; sennoside; Surgery; surgical site infection; Surgical Wound Infection - epidemiology; Surgical Wound Infection - prevention & control; Treatment Outcome; bowel preparation; sennoside; colon cancer; surgical site infection
• ISSN: 1015-9584; 0219-3108
• DOI: 10.1016/j.asjsur.2012.04.022

Summary Objective We retrospectively evaluated the usefulness of sennoside as an agent for mechanical bowel preparation prior to elective colon cancer surgery. Methods A total of 86 patients were given 12 mg of sennoside on the evening prior to resective surgery for colon cancer, followed by intravenous antimicrobial prophylaxis used on the day of surgery or until postoperative day 2. Results The incidence of surgical site infection in the study group was 4.7%, which was comparable to that in the historical control patients (3.5%, p > 0.99), who had received polyethylene glycol for mechanical bowel preparation prior to colon surgery. On multivariate logistic regression analysis, only body mass index ( p = 0.04) was an independent significant factor affecting the surgical site infection. The intraoperative spillage was not influenced by the presence of stenosis, although the amount of fecal matter was higher in the upstream colon segment ( p < 0.01) and downstream segment ( p = 0.07) in patients with a stenotic lesion occupying more than two-thirds of the lumen ( n = 29) than in those without such severe stenosis ( n = 57). Conclusion Sennoside seems to be an acceptable agent for mechanical bowel preparation even in patients with stenosis.