EFFICACY OF PREOPERATIVE BOWEL PREPARATION AT HOME

A preliminary study was designed to determine whether preoperative bow el preparation for colorectal surgery could be performed safely at hom e. Medical charts of 62 patients covering 4 years of elective major co lorectal surgery done by a single general surgeon were retrospectively reviewed. Patients were divided into four groups, depending on the ye ar in which they had surgery. Each patient had been given an easy-to-u nderstand instruction sheet as well as prescriptions for mannitol solu tion, neomycin, and erythromycin base. The changeover from hospital-ba sed to home-based bowel cleansing was gradual. In the first year of th e study, all patients had bowel preparation in hospital; in the final year, 88% of patients had bowel cleansing at home. Home bowel preparat ion resulted in no identifiable increase in morbidity or mortality. No death or wound infection occurred in any patient group. Preoperative home bowel preparation can be done safely by the patient without incre ased morbidity or mortality. Ordering this preparation for most colore ctal surgery patients could save about $150 million in hospital costs per year in the United States.