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Does a Preoperative Bowel Preparation Reduce Bowel Morbidity and Length of Stay After Scoliosis Surgery? A Randomized Prospective Study

Smith, John T. MD; Smith, Melissa S. CPNP

Journal of Pediatric Orthopaedics: December 2013 - Volume 33 - Issue 8 - p e69–e71
doi: 10.1097/BPO.0b013e318296e032

Background: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Level of Evidence: Level II.

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:

© 2013 by Lippincott Williams & Wilkins