Bowel Preparation with Oral Mannitol

Masahiro Tachi, Sintaro Sakurai, Seigo Nakamura, Ichiro Kimura, Mototaka Niwano, Takahiro Ohtawa, Tetsuo Yamana, Toru Kubota, Hideko Nagashima, Masashi Saegusa, Takeki Nisio

Department of Surgery, St. Luke's International Hospital

Between 2/86-2/88, 103 pts were evaluated. The pt drank 1.2 L of a 7.5% solution of mannitol during the morning of the day before surgery, combined with oral antibiotics and perioperative intravenous antibiotics. The mean time to complete the preparation was 8 hours. 96 pts thought this type of preparation was good. 12 pts vomited and 4 pts complained abdominal pain. No significant changes occured in the serum level of electrolytes, however, pts lost an average of 0.6 kilograms during preparation. The adequacy of bowel preparation was assessed at each operation, 68 pts had satisfactory results, however,46 pts had moderate and large amount of intestinal gass. Samples of colonic contents were compared in pts prepared by oral mannitol alone, oral mannitol with oral antibiotics and in pts who did not undergo any preparation. In the pts without reciving oral antibiotics, the mean number of microflora except E-coli was significantly lower than that of controles and oral antibiotics reduced all colonic microflora including E-coli. The postoperative infection developed in only one case (perineal wound infection). We conclude the 1-day mechanical preparation with 7.5% mannitol combined with oral antibiotics is a safe, effective and simple method for reducing the septic complications.

Key words
oral mannitol, mechanical bowel preparation, colonic microflora, postoperative wound infection

Reprint requests
Masahiro Tachi Department of Surgery, St. Luke's International Hospital
10-1 Akashi-cho, Chuo-ku, Tokyo, 104 JAPAN

Accepted
November 8, 1989

To read the PDF file you will need Abobe Reader installed on your computer.