Variation in bowel preparation among pediatric surgeons for elective colorectal surgery: A problem of equipoise or a knowledge gap of the available clinical evidence?
Document Type
Article
Publication Date
6-1-2015
Identifier
DOI: 10.1016/j.jpedsurg.2015.03.017
Abstract
PURPOSE: Despite rigorous data from adult literature demonstrating that oral antibiotics (OA) reduce infectious complications and mechanical bowel preparation (MBP) alone does not, MBP alone remains the preferred approach among pediatric surgeons. We aimed to explore the nature of this discrepancy through a survey of the American Pediatric Surgical Association membership.
METHODS: Surgeons were queried for their choice of bowel preparation, factors influencing their practice, and their impression of the strength and relevance of the adult literature to pediatric practice.
RESULTS: Surgeons who used MBP alone (31%) cited a reduction in stool burden and infectious complications as important factors, whereas surgeons choosing not to use OA (70%) reported a lack of benefit in reducing infectious complications as the primary reason. Although 53% of surgeons reported that evidence from adult literature was the most important influence, 73% of surgeons reported there was poor evidence supporting the use of OA (±MBP), and only 25% used a preparation supported by adult randomized data.
CONCLUSIONS: Wide variation exists among pediatric surgeons in the perceived utility of MBP and OA. Although the majority of pediatric surgeons cited the adult literature as the strongest influence on their practice, this is not consistent with stated perceptions or practice.
Journal Title
Journal of pediatric surgery
Volume
50
Issue
6
First Page
967
Last Page
971
MeSH Keywords
Administration, Oral; Antibiotic Prophylaxis; Child; Colon; Elective Surgical Procedures; Enema; Female; Humans; Male; Middle Aged; Pediatrics; Practice Patterns, Physicians'; Preoperative Care; Rectum; Surgeons; Surveys and Questionnaires
Keywords
mechanical bowel preparation; oral antibiotics; pediatric colorectal surgery
Recommended Citation
Feng, C., Sidhwa, F., Anandalwar, S., Pennington, E. C., Ziniel, S., Islam, S., St Peter, S. D., Abdullah, F., Goldin, A. B., Rangel, S. J. Variation in bowel preparation among pediatric surgeons for elective colorectal surgery: A problem of equipoise or a knowledge gap of the available clinical evidence? Journal of pediatric surgery 50, 967-971 (2015).
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