Letter to the editor on 'Preoperative bowel preparation in gynecologic oncology: a review of practice and an impetus to change' by Wells et al, Int J Gyn Cancer 2011; 21(6):1135-1142.

摘要

We read with interest the review of preoperative bowel preparation in gynecologic oncology and its widespread use in Canada. In particular, we commend the approach of the authors in challenging the "dogma" that often hinders improvements in the quality and safety of perioperative care.There is often a tension between the desire to improve the quality and safety of care, and a reluctance to consider changing elements of care, which are familiar but lack supporting evidence such as routine bowel preparation. Equally, there is often a resistance to the introduction of unfamiliar elements of care-even if supporting evidence exists.That surgeons can be dogmatic is not a recent phenomenon! In a textbook on operative gynecology published in Vienna in 1934, the authors stated, "We have been very cautious about allowing our patients out of bed at an early date, although this method has unquestionable advantages . . . Although the question of hospital space has made it necessary to give up the earlier-advocated 3 weeks of bed rest after a laparotomy, still we see to it, as a matter of principle, that the patient does not leave the bed before the ninth day."