Perspectives on the importance of postoperative ileus

Current Medical Research and Opinion
Filippo Sanfilippo, Gabriele Spoletini

Abstract

Post-operative ileus (POI) is a common condition after surgery. Failure to restore adequate bowel function after surgery generates a series of complications and it is associated to patients frustration and discomfort, worsening their perioperative experience. Even mild POI can be source of anxiety and could be perceived as a drop out from the "straight-forward" pathway. Enhanced recovery programmes have emphasized the importance of early commencement of oral diet, avoiding the ancient dogmata of prolonged gastric decompression and fasting. These protocols with early oral feeding and mobilization have led to improved perioperative management and have decreased hospital length of stay, ameliorating patient's postoperative experience as well. Nonetheless, the incidence of POI is still high especially after major open abdominal surgery. In order to decrease the incidence of POI, minimally-invasive surgical approaches and minimization of surgical manipulation have been suggested. From a pharmacological perspective, a meta-analysis of pro-kinetics showed beneficial results with alvimopan, although its use has been limited by the augmented risk of myocardial infarction and the high costs. A more simple approach based on the postoperat...Continue Reading

References

Jun 1, 1990·Annals of Surgery·J H WaldhausenB D Schirmer
Aug 22, 2007·Diseases of the Colon and Rectum·Miranda K Y Chan, Wai Lun Law
Jul 18, 2012·Nature Reviews. Gastroenterology & Hepatology·Sjoerd H W van BreeGuy E Boeckxstaens
May 24, 2014·Scandinavian Journal of Gastroenterology·Cecilie OkholmMichael Patrick Achiam
Jun 7, 2014·Current Opinion in Clinical Nutrition and Metabolic Care·Morgan Le GuenMarc Fischler
Aug 29, 2014·JAMA : the Journal of the American Medical Association·Lori FrankUNKNOWN Patient-Centered Outcomes Research Institute

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Citations

Mar 16, 2016·The Journal of Surgical Research·Vahagn C Nikolian, John C Byrn
Oct 15, 2019·Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology·Ünal TurkayAhmet Kale
Oct 22, 2019·Diseases of the Colon and Rectum·Fabian GrassDavid W Larson
Nov 17, 2020·The Spine Journal : Official Journal of the North American Spine Society·Aaron J BucklandJ Alex Thomas

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