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The Western Journal of Medicine May 1993
Topics: Humans; Intestinal Pseudo-Obstruction; Postoperative Complications; Suggestion
PubMed: 8342279
DOI: No ID Found -
Ugeskrift For Laeger Oct 2019Post-operative ileus (POI) is a common complication following especially open abdominal surgery. This review is an overview of the incidence, the current treatment and... (Review)
Review
Post-operative ileus (POI) is a common complication following especially open abdominal surgery. This review is an overview of the incidence, the current treatment and the future perspectives for POI. Adherence to the enhanced recovery programmes is of great importance, as it has shown a decreased length of POI and length of stay. No single treatment modality has proven effective as a cure for POI.
Topics: Humans; Ileus; Incidence; Postoperative Complications
PubMed: 31617478
DOI: No ID Found -
Tidsskrift For Den Norske Laegeforening... Apr 2023Gallstones are common, but rarely cause ileus. This case report illustrates the clinical course of a patient who developed gallstone ileus without any previously...
Gallstones are common, but rarely cause ileus. This case report illustrates the clinical course of a patient who developed gallstone ileus without any previously identified gallstone symptoms.
Topics: Humans; Gallstones; Intestinal Obstruction; Ileus
PubMed: 37097249
DOI: 10.4045/tidsskr.22.0452 -
Journal of Gastrointestinal Surgery :... Nov 2020Chewing gum as a form of sham feeding is an inexpensive and well-tolerated means of promoting gastrointestinal motility following major abdominal surgery. Although... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Chewing gum as a form of sham feeding is an inexpensive and well-tolerated means of promoting gastrointestinal motility following major abdominal surgery. Although recognised by the Enhanced Recovery After Surgery (ERAS) Society as one of the multimodal approaches to expedite recovery after surgery, strong evidence to support its use in routine postoperative practice is lacking.
METHODOLOGY
A comprehensive literature review of all randomised controlled trials (RCTs) was performed in the Medline and Embase databases between 2000 and 2019. Studies were selected to compare the use of chewing gum versus standard care in the management of postoperative ileus (POI) in adults undergoing colorectal surgery. The primary outcome assessed was the incidence of POI. Secondary outcomes included time to passage of flatus, time to defecation, total length of hospital stay and mortality.
RESULTS
Sixteen RCTs were included in the systematic review, of which ten (970 patients) were included in the meta-analysis. The incidence of POI was significantly reduced in patients utilising chewing gum compared to those having standard care (RR 0.55, 95% CI 0.39, 0.79, p = 0.0009). These patients also had a significant reduction in time to passage of flatus (WMD - 0.31, 95% CI - 0.36, - 0.26, p < 0.00001) and time to defecation (WMD - 0.47, 95% CI - 0.60, - 0.34, p < 0.00001), without significant differences in the total length of hospital stay or mortality.
CONCLUSION
The use of chewing gum after colorectal surgery is a safe and effective intervention in reducing the incidence of POI and merits routine use alongside other ERAS pathways in the postoperative setting.
Topics: Abdomen; Adult; Chewing Gum; Colorectal Surgery; Gastrointestinal Motility; Humans; Ileus; Length of Stay; Postoperative Complications
PubMed: 32103455
DOI: 10.1007/s11605-019-04507-3 -
Anesthesiology May 2021
Topics: Cystectomy; Fluid Therapy; Goals; Humans; Ileus; Prospective Studies
PubMed: 33570585
DOI: 10.1097/ALN.0000000000003701 -
Anesthesiology May 2021
Topics: Cystectomy; Fluid Therapy; Goals; Humans; Ileus; Prospective Studies
PubMed: 33570599
DOI: 10.1097/ALN.0000000000003703 -
Anesthesiology May 2021
Topics: Cystectomy; Fluid Therapy; Goals; Humans; Ileus; Prospective Studies
PubMed: 33570618
DOI: 10.1097/ALN.0000000000003702 -
The Primary Care Companion For CNS... Nov 2021
Topics: Antipsychotic Agents; Humans; Ileus
PubMed: 34738351
DOI: 10.4088/PCC.21cr02961 -
The British Journal of Surgery Jan 2020Ileus is common after elective colorectal surgery, and is associated with increased adverse events and prolonged hospital stay. The aim was to assess the role of... (Observational Study)
Observational Study
BACKGROUND
Ileus is common after elective colorectal surgery, and is associated with increased adverse events and prolonged hospital stay. The aim was to assess the role of non-steroidal anti-inflammatory drugs (NSAIDs) for reducing ileus after surgery.
METHODS
A prospective multicentre cohort study was delivered by an international, student- and trainee-led collaborative group. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The primary outcome was time to gastrointestinal recovery, measured using a composite measure of bowel function and tolerance to oral intake. The impact of NSAIDs was explored using Cox regression analyses, including the results of a centre-specific survey of compliance to enhanced recovery principles. Secondary safety outcomes included anastomotic leak rate and acute kidney injury.
RESULTS
A total of 4164 patients were included, with a median age of 68 (i.q.r. 57-75) years (54·9 per cent men). Some 1153 (27·7 per cent) received NSAIDs on postoperative days 1-3, of whom 1061 (92·0 per cent) received non-selective cyclo-oxygenase inhibitors. After adjustment for baseline differences, the mean time to gastrointestinal recovery did not differ significantly between patients who received NSAIDs and those who did not (4·6 versus 4·8 days; hazard ratio 1·04, 95 per cent c.i. 0·96 to 1·12; P = 0·360). There were no significant differences in anastomotic leak rate (5·4 versus 4·6 per cent; P = 0·349) or acute kidney injury (14·3 versus 13·8 per cent; P = 0·666) between the groups. Significantly fewer patients receiving NSAIDs required strong opioid analgesia (35·3 versus 56·7 per cent; P < 0·001).
CONCLUSION
NSAIDs did not reduce the time for gastrointestinal recovery after colorectal surgery, but they were safe and associated with reduced postoperative opioid requirement.
Topics: Adult; Aged; Anti-Inflammatory Agents, Non-Steroidal; Colectomy; Elective Surgical Procedures; Female; Humans; Ileus; Kaplan-Meier Estimate; Male; Middle Aged; Patient Safety; Postoperative Care; Postoperative Complications; Proctectomy; Proportional Hazards Models; Prospective Studies; Recovery of Function; Time Factors; Treatment Outcome
PubMed: 31595986
DOI: 10.1002/bjs.11326 -
Physiological Reports Feb 2021Prolonged postoperative ileus (PPOI) occurs in around 15% of patients after major abdominal surgery, posing a significant clinical and economic burden. Significant fluid...
AIM
Prolonged postoperative ileus (PPOI) occurs in around 15% of patients after major abdominal surgery, posing a significant clinical and economic burden. Significant fluid and electrolyte changes may occur peri-operatively, potentially contributing to PPOI; however, this association has not been clearly elucidated. A joint clinical-theoretical study was undertaken to evaluate peri-operative electrolyte concentration trends, their association with ileus, and predicted impact on bioelectrical slow waves in interstitial cells of Cajal (ICC) and smooth muscle cells (SMC).
METHODS
Data were prospectively collected from 327 patients undergoing elective colorectal surgery. Analyses were performed to determine associations between peri-operative electrolyte concentrations and prolonged ileus. Biophysically based ICC and SMC mathematical models were adapted to evaluate the theoretical impacts of extracellular electrolyte concentrations on cellular function.
RESULTS
Postoperative day (POD) 1 calcium and POD 3 chloride, sodium were lower in the PPOI group (p < 0.05), and POD3 potassium was higher in the PPOI group (p < 0.05). Deficits beyond the reference range in PPOI patients were most notable for sodium (Day 3: 29.5% ileus vs. 18.5% no ileus, p = 0.04). Models demonstrated an 8.6% reduction in slow-wave frequency following the measured reduction in extracellular NaCl on POD5, with associated changes in cellular slow-wave morphology and amplitude.
CONCLUSION
Low serum sodium and chloride concentrations are associated with PPOI. Electrolyte abnormalities are unlikely to be a primary mechanism of ileus, but their pronounced effects on cellular electrophysiology predicted by modeling suggest these abnormalities may adversely impact motility recovery. Resolution and correction of electrolyte abnormalities in ileus may be clinically relevant.
Topics: Aged; Biomarkers; Chlorides; Female; Gastrointestinal Motility; Humans; Ileus; Interstitial Cells of Cajal; Male; Models, Biological; Muscle, Smooth; Periodicity; Postoperative Complications; Sodium; Time Factors; Water-Electrolyte Balance
PubMed: 33527737
DOI: 10.14814/phy2.14735