Mechanisms and Treatment of Postoperative Ileus

Abstract

To review the pathogenesis and treatment of postoperative ileus. Data Sources: Data collected for this review were identified from a MEDLINE database search of the Englishlanguage literature. The exact indexing terms were "postoperative ileus," "treatment," "etiology," and "pathophysiology." Previous review articles and pertinent references from those articles were also used. Study Selection: All relevant studies were included. Only articles that were case presentations or that mentioned postoperative ileus in passing were excluded.

Enhanced recovery after surgery (ERAS) protocols: Time to change practice?

“…3,7,67,68 The etiology of postoperative ileus is multifactoral, with bowel function relying on a combination of the enteric and central nervous systems, hormonal influences, neurotransmitters and local inflammatory pathways. 69 Surgical stress, bowel handling, opioids and intraoperative fluid resuscitation can disrupt these normal arrangements within the gastrointestinal tract and lead to postoperative ileus and impaired gastrointestinal absorptive function. 64 Factors that help reduce this include epidural anesthesia, minimally invasive surgery, gentle tissue handling, avoiding of fluid overload 70 and early feeding.…”

Effect of bisacodyl on postoperative bowel motility in elective colorectal surgery: a prospective, randomized trial

“…It leads to patient discomfort, may contribute to related complications and consequently to a prolonged length of hospital stay. Multiple factors, including surgical manipulation, inflammatory mediators, autonomic dysfunction, electrolyte and fluid imbalances, and analgesics (opioids) contribute to the etiology [1,2].…”

Early recovery pathway for hepatectomy: data-driven liver resection care and recovery

“…As one of the major causes of prolonged length of stay, it is also associated with increased all-cause morbidity regardless of procedure type (16). Efforts to decrease post-operative ileus include judicious use of opioids at all phases of perioperative care, in addition to adjunctive use of non-steroidal anti-inflammatories and epidural analgesia where clinically appropriate (17).…”