Factors affecting recovery of postoperative bowel function after pediatric laparoscopic surgery

Abstract

Background and Aims:Laparoscopic pediatric surgery allows a rapid postoperative rehabilitation and hospital discharge. However, the optimal postoperative pain management preserving advantages of this surgical technique remains to be determined. This study aimed to identify factors affecting the postoperative recovery of bowel function after laparoscopic surgery in children.Material and Methods:A retrospective analysis of factors affecting recovery of bowel function in children and infants undergoing laparoscopic surgery between January 1, 2009 and September 30, 2009, was performed. Factors included were: Age, weight, extent of surgery (extensive, regional or local), chronic pain (sickle cell disease or chronic intestinal inflammatory disease), American Society of Anaesthesiologists status, postoperative analgesia (ketamine, morphine, nalbuphine, paracetamol, nonsteroidal anti-inflammatory drugs [NSAIDs], nefopam, regional analgesia) both in the Postanesthesia Care Unit and in the surgical ward; and surgical complications. Data analysis used classification and regression tree analysis (CART) with a 10-fold cross validation.Results:One hundred and sixty six patients were included in the analysis. Recovery of bowel function depended upon: The extent of surgery, the occurrence of postoperative surgical complications, the administration of postoperative morphine in the surgical ward, the coadministration of paracetamol and NSAIDs and/or nefopam in the surgical ward and the emergency character of the surgery. The CART method generated a decision tree with eight terminal nodes. The percentage of explained variability of the model and the cross validation were 58% and 49%, respectively.Conclusion:Multimodal analgesia using nonopioid analgesia that allows decreasing postoperative morphine consumption should be considered for the speed of bowel function recovery after laparoscopic pediatric surgery.

Effect of Ultrasound-Guided Quadratus Lumborum Block Preemptive Analgesia on Postoperative Recovery of Patients with Open Radical Colon Cancer Surgery: A Retrospective Study

“…42 Postoperative recovery speed is closely associated with the extent of surgical trauma, postoperative analgesia, early postoperative ambulation, and postoperative intestinal function recovery. 43,44 Our results showed that these parameters in Group Q were significantly improved compared with those in Group C (P<0.01). Our findings are very similar to those of Wang et al, 45 who reported that QLB significantly reduced perioperative opioid requirement, alleviated postoperative analgesia, shortened the time to first ambulation and flatus, and accelerated postoperative recovery of the patients undergoing laparoscopic colorectal surgery.…”

Retrospective study on recovery of 521 gastrointestinal tumor patients after laparoscopic surgery

“…Bowel sound that could be heard in two or more regions for three times or more was regarded as recovery, and the earliest time was set as the time (h) of the recovery of bowel sound. The cut-off values for the indexes were based on Michelet et al ( 12 – 15 ).…”

Efficacy and safety of gasless single-port laparoscopic-assisted radical rectal cancer surgery: A single-center prospective observational study

“…Improving the quality of life of rectal cancer patients and reducing surgical trauma are among the directions in which minimally invasive surgery is striving to develop (2). Many studies have demonstrated that minimally invasive rectal cancer surgery has many advantages over traditional open surgery, such as less stress (3), fewer effect on urinary function and sexual function (4), faster recovery of gastrointestinal function (5). However, minimally invasive rectal cancer surgery with gas insu ation still has its limitations.…”