Well, well, well...I found out some rather interesting info on the prep issue! I called and talked to the nurse and told her I was concerned that I wouldn't be cleaned out with the minimal prep they had told me to do (liquids the day before, 2 doses of the fleet). She said that the prep was
not a major concern for colectomy or resection...only for colonoscopy where they had to be able to see everything. I said that was surprising, and that I would think that if there was stool in the colon it could increase postoperative infection. She said that they
used to think that as well, but that current clinical practice and research has shown that there is no increase in infection whether the colon is full or empty! She said that the only reason they continue to do a prep at all is to make the colon a little smaller and easier to manipulate, so she said not to worry about
it. I also asked about
prophylactic oral antibiotics, and she said that they know now that oral antibiotics aren't necessary, and that they actually increase post-op diarrhea. She said they'll start IV antibiotics prior to the surgery in holding and will continue it throughout the surgery. She said that many colorectal surgeons still use the "old" methods of complete bowel prep and oral antibiotics, but that there is no clinical benefit from it and can actually cause complications (dehydration from prep, etc). She said that the doc was one of the surgeons that helped establish the new practice guidelines for it. After I got off the phone, I figured I'd do my own internet search just to make sure...turns out she's exactly right! Research confirms it, and the ASCRS even has those points included in their own "Perioperative Management" section. So yeah for me!! I get to enjoy some Christmas after all
