| Does Mechanical Bowel Preparation Improve Quality of Laparoscopic Nephrectomy? Propensity Score-matched Analysis in Japanese Series. | |
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MedLine Citation:
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PMID: 23273073 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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OBJECTIVE: To assess the effect of mechanical bowel preparation (MBP) before laparoscopic nephrectomy in terms of operation time and perioperative complications. MATERIALS AND METHODS: Patients undergoing laparoscopic nephrectomy for T1-T3 tumors were identified in the Japanese Diagnosis Procedure Combination database from 2008 to 2010. The patients were stratified into a preoperative MBP group (polyethylene glycol electrolyte, magnesium citrate solution, and sodium picosulfate) and a non-MBP group and were matched using one-to-one propensity score matching according to age, sex, Charlson score, T category, hospital volume, and hospital academic status. The operation time, postoperative length of stay, and overall complication rate were assessed by multivariate regression analyses. RESULTS: Of 2740 patients in 355 hospitals, 1110 pairs were generated. The median operation time, postoperative stay, and overall complication rate (MBP vs non-MBP group) was 278 and 268 minutes (P <.004), 10.3 and 10.0 days (P = .695), and 11.8% and 11.4% (P = .740), respectively. The multivariate regression analyses did not find significant superiority of MBP for the 3 endpoints (all P >.05). A shorter operation time was significantly associated with female sex and early-stage tumor. Older age, greater Charlson score, and lower hospital volume adversely affected the postoperative stay and overall complication rate. Stage T3 tumor was unfavorable for the postoperative stay. CONCLUSION: Our large-scale propensity score-matched analysis did not demonstrate a benefit for MBP in operation time, postoperative stay, or overall complications. The results suggest that MBP can be safely omitted before laparoscopic nephrectomy for T1-T3 tumors. |
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Authors:
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Toru Sugihara; Hideo Yasunaga; Hiromasa Horiguchi; Tetsuya Fujimura; Hiroaki Nishimatsu; Kazuhiko Ohe; Shinya Matsuda; Kiyohide Fushimi; Michael W Kattan; Yukio Homma |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Urology Volume: 81 ISSN: 1527-9995 ISO Abbreviation: Urology Publication Date: 2013 Jan |
Date Detail:
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Created Date: 2012-12-31 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0366151 Medline TA: Urology Country: United States |
Other Details:
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Languages: eng Pagination: 74-9 Citation Subset: IM |
Copyright Information:
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Copyright © 2013 Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Urology, Shintoshi Hospital, Iwata, Japan; Department of Urology, University of Tokyo, Tokyo, Japan. Electronic address: ezy04707@nifty.com. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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