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Postoperative Ileus.
Clin Colon Rectal Surg 2019; 32(3):166-170CC

Abstract

Postoperative ileus (POI) is a common complication following colon and rectal surgery, with reported incidence ranging from 10 to 30%. It can lead to increased morbidity, cost, and length of stay. Although definitions vary considerably in the literature, in its pathologic form, it can be characterized by a temporary inhibition of gastrointestinal motility after surgical intervention due to nonmechanical causes that prevents sufficient oral intake. Various risk factors for development of POI have been identified including increasing age, American Society of Anesthesiologists scores 3 to 4, open approach, operative difficulty, operative duration more than 3 hours, bowel handling, drop in hematocrit or need for a transfusion, increasing crystalloid administration, and delayed mobilization. While treatment is expectant and supportive, significant investigations into strategies to mitigate development of POI or shorten its duration have been undertaken with mixed results. There is significant evidence to suggest that a minimally invasive approach and multimodal pain regimens reduce the development of POI. The beneficial effect of chewing gum, alvimopan, and enhanced recovery after surgery protocols may decrease development of POI in selected groups of patients who undergo elective colorectal surgery, and shorten time to return of bowel function, but overall, the data remain inconclusive.

Authors+Show Affiliations

Division of Colon and Rectal Surgery, University of Massachusetts, Boston, Massachusetts.Division of Colon and Rectal Surgery, University of Massachusetts, Boston, Massachusetts.Division of Colon and Rectal Surgery, University of Massachusetts, Boston, Massachusetts.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

31061645

Citation

Harnsberger, Cristina R., et al. "Postoperative Ileus." Clinics in Colon and Rectal Surgery, vol. 32, no. 3, 2019, pp. 166-170.
Harnsberger CR, Maykel JA, Alavi K. Postoperative Ileus. Clin Colon Rectal Surg. 2019;32(3):166-170.
Harnsberger, C. R., Maykel, J. A., & Alavi, K. (2019). Postoperative Ileus. Clinics in Colon and Rectal Surgery, 32(3), pp. 166-170. doi:10.1055/s-0038-1677003.
Harnsberger CR, Maykel JA, Alavi K. Postoperative Ileus. Clin Colon Rectal Surg. 2019;32(3):166-170. PubMed PMID: 31061645.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Postoperative Ileus. AU - Harnsberger,Cristina R, AU - Maykel,Justin A, AU - Alavi,Karim, Y1 - 2019/04/02/ PY - 2020/05/01/pmc-release PY - 2019/5/8/entrez PY - 2019/5/8/pubmed PY - 2019/5/8/medline KW - colorectal complication KW - paralytic ileus KW - postoperative ileus SP - 166 EP - 170 JF - Clinics in colon and rectal surgery JO - Clin Colon Rectal Surg VL - 32 IS - 3 N2 - Postoperative ileus (POI) is a common complication following colon and rectal surgery, with reported incidence ranging from 10 to 30%. It can lead to increased morbidity, cost, and length of stay. Although definitions vary considerably in the literature, in its pathologic form, it can be characterized by a temporary inhibition of gastrointestinal motility after surgical intervention due to nonmechanical causes that prevents sufficient oral intake. Various risk factors for development of POI have been identified including increasing age, American Society of Anesthesiologists scores 3 to 4, open approach, operative difficulty, operative duration more than 3 hours, bowel handling, drop in hematocrit or need for a transfusion, increasing crystalloid administration, and delayed mobilization. While treatment is expectant and supportive, significant investigations into strategies to mitigate development of POI or shorten its duration have been undertaken with mixed results. There is significant evidence to suggest that a minimally invasive approach and multimodal pain regimens reduce the development of POI. The beneficial effect of chewing gum, alvimopan, and enhanced recovery after surgery protocols may decrease development of POI in selected groups of patients who undergo elective colorectal surgery, and shorten time to return of bowel function, but overall, the data remain inconclusive. SN - 1531-0043 UR - https://www.unboundmedicine.com/medline/citation/31061645/Postoperative_Ileus_ L2 - http://www.thieme-connect.com/DOI/DOI?10.1055/s-0038-1677003 DB - PRIME DP - Unbound Medicine ER -