Review of the Pathophysiology and Management of Postoperative Ileus

Mattei, Peter; Rombeau, John L.

doi:10.1007/s00268-005-0613-9

Cited by 202 publications

(173 citation statements)

References 80 publications

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“…This may be due to interruption of normal gastrointestinal reflexes triggered by orogastric secretions. Ileus does, of course, have several contributing factors, including autonomic nervous system dysfunction, inflammatory response, anaesthetic and opioid administration, and gastrointestinal hormone disruption [18]. Moreover, in our trial, we demonstrated that the time to starting an oral diet was slightly shorter in the group without decompression (P = 0.013), but the length of hospital stay, morbidity and mortality did not differ significantly between the two groups.…”

Section: Discussionmentioning

confidence: 50%

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Naso-gastric or naso-jejunal decompression after partial distal gastrectomy for gastric cancer. Final results of a multicenter prospective randomized trial

et al. 2013

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Background Only a few, small, monocentric randomized controlled trials (RCTs) have compared routine vs. no placement of a nasogastric or nasojejunal tube decompression (NG/NJT) in patients undergoing partial distal gastrectomy (PDG) for gastric cancer. However, to our knowledge, no multicenter prospective RCT has analyzed the role of decompression after both the Billroth II (BII) procedure and Roux-en-Y (RY) gastrojejunostomy.The aim of this study was to determine whether NG/NJT prevents the consequences of postoperative ileus after PDG for gastric cancer after both BII reconstruction and RY. Methods Two hundred seventy patients undergoing PDG for gastric cancer were randomly assigned NG/NJT placement (NG/NJT group) or not (no-NG/NJT group) with either Billroth II gastrojejunostomy or Roux-en-Y gastrojejunostomy. The patients were monitored for postoperative complications, mortality, and postoperative course. Results By January 2010 to June 2012, among 270 patients undergoing PDG for gastric cancer, 134 were randomly assigned to NG/NJT placement (NG/NJT group) and 136 to no decompression (no-NG/NJT group). Time to passage of flatus was significantly shorter in the NG/NJT group than in the no-NG/NJT group, but only after RY reconstruction (3.3 ± 1.5 vs. 4.3 ± 1.6 days, P \ 0.001, respectively).

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Section: Discussionmentioning

confidence: 50%

“…Moreover, according to some pathophysiologic studies [18], decompression may not prevent but actually facilitates postoperative ileus. This may be due to interruption of normal gastrointestinal reflexes triggered by orogastric secretions.…”

Section: Discussionmentioning

confidence: 99%

Naso-gastric or naso-jejunal decompression after partial distal gastrectomy for gastric cancer. Final results of a multicenter prospective randomized trial

et al. 2013

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“…This may be because such patients develop more complications, including intra-abdominal sepsis, and because lower serum albumin causes swelling and edema of the intestine [24] , resulting in paralytic ileus. Clearly, there would be other factors contributing to postoperative bowel function, such as narcotics administration and electrolyte status [25][26][27] . Prolonged hospitalization in hypoalbuminemic patients may be the result of higher rates of postoperative complication and delayed bowel recovery.…”

Section: Discussionmentioning

confidence: 99%

Pre-operative hypoalbuminemia is a major risk factor for postoperative complications following rectal cancer surgery

Lohsiriwat¹,

Lohsiriwat²,

Boonnuch³

et al. 2008

WJG

119

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AIM:To determine the relationship between preoperative hypoalbuminemia and the development of complications following rectal cancer surgery, as well as postoperative bowel function and hospital stay. METHODS:The medical records of 244 patients undergoing elective oncological resection for rectal adenocarcinoma at Siriraj Hospital during 2003 and 2006 were reviewed. The patients had pre-operative serum albumin assessment. Albumin less than 35 g/L was recognized as hypoalbuminemia. Postoperative outcomes, including mortality, complications, time to first bowel movement, time to first defecation, time to resumption of normal diet and length of hospital stay, were analyzed. RESULTS:The patients were 139 males (57%) and 105 females (43%) with mean age of 62 years. Fifty-six patients (23%) had hypoalbuminemia. Hypoalbuminemic patients had a significantly larger tumor size and lower body mass index compared with non-hypoalbuminemic patients (5.5 vs 4.3 cm; P < 0.001 and 21.9 vs 23.2 kg/m 2 ; P = 0.02, respectively). Thirty day postoperative mortality was 1.2%. Overall complication rate was 25%. Hypoalbuminemic patients had a significantly higher rate of postoperative complications (37.5% vs 21.3%; P = 0.014). In univariate analysis, hypoalbuminemia and ASA status were two risk factors for postoperative complications. In multivariate analysis, hypoalbuminemia was the only significant risk factor (odds ratio 2.22, 95% CI 1.17-4.23; P < 0.015). Hospitalization in hypoalbuminemic patients was significantly longer than that in non-hypoalbuminemic patients (13 vs 10 d, P = 0.034), but the parameters of postoperative bowel function were not significantly different between the two groups. CONCLUSION:Pre-operative hypoalbuminemia is an independent risk factor for postoperative complications following rectal cancer surgery.

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“…1 The incidence of caesarean sections has shown drastic increase each year worldwide. Consequently, postoperative care of such females required some attention.…”

Section: Introductionmentioning

confidence: 99%

“…4 Postoperative ileus (POI) usually follows caesarean section. 1 Postoperative ileus is illustrated by a temporary inhibition of gut motility leading to wide range of events culminating in increased burden on healthcare. 5,6 Postoperative ileus is defined as temporary inhibition of coordinated bowel function after surgery, and may follow surgery involving abdominal viscera.…”

Section: Introductionmentioning

confidence: 99%

Role of Chewing Gum on Early Recovery of Females After Caesarean Section

Wajid¹,

Huma²,

Mobusher³

2016

Annals KEMU

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Background: The incidence of Caesarean section is increasing day by day, which is usually conducted under spinal anesthesia. It is done on lower abdominal region and for this reason; the working of digestive system can slow down in the coming period. This is known as ileus, and is distressing for the patient but the way to prevent this problem, is there. One possible way of avoiding this consequence is chewing gum which tricks the body into thinking it is eating making the bowel start its function again. Objective: To compare the effect of chewing gum as compared to no intervention for early recovery of bowel system after lower segment caesarean section at term. Methodology: This randomized controlled trial was conducted on 100 females who were planned to undergo caesarean section. Informed consent was obtained and demographic details were noted. In group A,

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Review of the Pathophysiology and Management of Postoperative Ileus

Cited by 202 publications

References 80 publications

Naso-gastric or naso-jejunal decompression after partial distal gastrectomy for gastric cancer. Final results of a multicenter prospective randomized trial

Naso-gastric or naso-jejunal decompression after partial distal gastrectomy for gastric cancer. Final results of a multicenter prospective randomized trial

Pre-operative hypoalbuminemia is a major risk factor for postoperative complications following rectal cancer surgery

Role of Chewing Gum on Early Recovery of Females After Caesarean Section

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