Constipation is a common problem after surgery for adolescent idiopathic scoliosis (AIS), with bowel morbidity being reported as high as 78%. The purpose of this study was to determine if a preoperative bowel preparation reduces the incidence of bowel morbidity after surgery for AIS.
This is an IRB-approved randomized, prospective study of 60 consecutive patients who underwent surgery for AIS. After consent to participate was signed by the patients’ family, patients were randomized to either a preoperative bowel preparation (group A) or no bowel preparation (group B). Bowel morbidity data were then collected and compared postoperatively.
Complete data were available for 27 patients in group A and 28 in group B. Postoperatively, we found that group A had less weight gain (P<0.09), fewer postoperative bowel medications (P<0.023), and a shorter time to first bowel movement (P<0.03) when compared with group B. Two patients in group B had persistent constipation after discharge, one requiring readmission to the hospital. One patient in group B developed a postoperative wound infection. There were no adverse events in group A postoperatively.
This study did show a modest reduction in some aspects of bowel morbidity when patients had a preoperative bowel preparation before scoliosis surgery. However, these differences did not reach statistical significance. Therefore, we do not recommend routine preoperative bowel preparations for AIS patients.
Department of Orthopaedics, University of Utah School of Medicine, Primary Children’s Medical Center, Salt Lake City, UT
The authors declare no conflicts of interest.
Reprints: John T. Smith, MD, Department of Orthopaedics, University of Utah School of Medicine, Primary Children’s Medical Center, 100 N. Mario Capecchi Drive, Suite 4550, Salt Lake City, UT 84113. E-mail: firstname.lastname@example.org.