The duration of postoperative ileus after elective colectomy is correlated to surgical specialization

Abstract

Restoration of normal intestinal function after elective open colectomy takes 3 (PG) to 4 (PS) days. In our series, specialized training in colorectal surgery has a positive impact on the duration of postoperative ileus. Surgical specialization should be considered an important parameter in future clinical trials aiming to minimize postoperative ileus.

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

“…Neither the type of surgery nor the level of training of the operating surgeon was different. Gervaz et al reported of earlier return of gastrointestinal function if the procedure was performed by a specialist colorectal surgeon compared to general surgeons [31]. Unfortunately, there is no mentioning of duration of surgery in their study.…”

Systematic review with meta-analysis of the impact of surgical fellowship training on patient outcomes

“…Of the 11 studies comparing outcomes for attending surgeons with versus without fellowship training, two found no difference between groups for patient mortality. One study found decreased survival in patients undergoing aortic aneurysm repair, treated by a general surgeon rather than a vascular or cardiothoracic fellowship‐trained surgeon.…”

“…There were three different types of comparison used in the 23 studies. Eleven studies compared patient outcomes achieved by attending surgeons with versus those without fellowship training in their specialist field. Six studies compared patient outcomes for centres with affiliated fellowship training programmes with those without, or outcomes for a single centre before and after the introduction of a fellowship programme.…”

“…1). All articles were cohort studies, of which six 15,22,31,33,35,36 involved prospectively created databases. Some 19 articles originated from North America, with others coming from China, Europe and Australia.…”

A Comprehensive Review of Evidence-Based Strategies to Prevent and Treat Postoperative Ileus

“…A recent retrospective study of 88 abdominal surgery patients found that the duration of POI correlates with total surgery time, blood loss and total opiate dose [19]. Gervaz et al [20] studied 124 patients undergoing laparotomy for colectomy (median age, 68 years) and found the duration of ileus significantly reduced in those cases performed by a colorectal surgeon and when opioid analgesia lasted for less than 2 days.…”