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ORIGINAL ARTICLE
Purpose: This study aimed to examine extended postoperative ileus and its risk factors in patients who have undergone abdominal surgery, and discuss the techniques of prevention and management thereof the light of related risk factors connected with our study. Methods: This prospective study involved 103 patients who had undergone abdominal surgery. The
effects of age, gender, diagnosis, surgical operation conducted, excessive small intestine manipulation, opioid analgesic usage time, and systemic inflammation on the time required for the restoration of intestinal motility were investigated. The parameters were investigated prospectively. Results: Regarding the factors that affected the restoration of gastrointestinal motility, resection operation type, longer operation period, longer opioid analgesics use period, longer nasogastric catheter use
period, and the presence of systemic inflammation were shown to retard bowel motility for 3 days or more. Conclusion: Our
study confirmed that unnecessary analgesics use in patients with pain tolerance with non-steroid anti-inflammatory drugs,
excessive small bowel manipulation, prolonged nasogastric catheter use have a direct negative effect on gastrointestinal
motility. Considering that an exact treatment for postoperative ileus has not yet been established, and in light of the risk factors mentioned above, we regard that prevention of postoperative ileus is the most effective way of coping with intestinal
dysmotility.
Key Words: Ileus, Abdominal surgery, Intestinal complications
INTRODUCTION
the most significant causes of extended hospitalization folDespite the advancements in surgical techniques and
Received April 4, 2011, Revised July 14, 2011, Accepted July 19, 2011
Correspondence to: Aybala Agac Ay
Department of General Surgery, Viransehir State Hospital, Viransehir, Sanliurfa, Turkey
Tel: 905419519509, Fax: 904143567228, E-mail: draybala.a@gmail.com
cc Journal of the Korean Surgical Society is an Open Access Journal. All articles are distributed under the terms of the Creative Commons
Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use,
distribution, and reproduction in any medium, provided the original work is properly cited.
Postoperative ileus
etiology .
METHODS
with the anesthesiologist. The body temperature of the patient during the operation was maintained between 35.8C
o
diversion.
thesurgery.or.kr
243
days.
(SD, 1.1). Of the patients, 46.6% did not have their nasogas-
12,000/mm .
tient age and the time required for the restoration of in-
RESULTS
The subjects consisted of 66 male and 37 female patients
244
Gastric cancer
Colon cancer
Rectum cancer
Oesophagus cancer
Perforation
Pancreas cancer
Retroperitoneal malign tm.
Trauma
Total
thesurgery.or.kr
Postoperative ileus
operation period, longer opioid analgesics use period, longer nasogastric catheter use period, and the presence of
DISCUSSION
Table 2. Risk factors associated with gastrointestinal (GI) recovery
time
3 days or
more
Although surgeons define postoperative ileus as the detive period, it is not possible to find a perfect and stand-
P-value
0.944
1.000
1.000
0.001
0.001
0.001
0.001
0.001
0.030
tro-intestinal tract is affected following a surgical operation. While the small intestine recovers its motility in the
to 48 hours for the stomach, and until a couple of days for
the colon. A functional definition of the entity postoperative ileus can be the retardation of normal bowel activity to the uncoordinated motility of gastrointestinal system in this period. This state of retardation can be called
as postoperative ileus if it goes beyond the third day.
Although there are studies that refer to this condition that
occurs secondarily to surgical operation as primer ileus,
the term postoperative ileus has been adopted by most
NG, nasogastric.
Age
Gender
Diagnosis (malign)
Operation type
(resection)
Operation time
Duration of narcotic
analgesic use
Duration drainage
with NG
Systemic
inflammation
P-value
OR
% 95 CI
0.922
0.971
0.815
0.001
1.002
1.015
0.848
4.656
0.966
0.447
0.214
1.968
1.039
2.304
3.364
11.014
0.001
0.001
14.924
6.138
5.461
3.171
40.780
11.879
0.001
7.294
3.005
17.705
0.032
0.169
0.033
0.862
thesurgery.or.kr
Age
Operation time
Duration of narcotic
analgesic use
Duration drainage with NG
P-value
OR
% 95 CI
0.073
0.001
0.003
0.936
7.016
4.081
0.871
2.108
1.639
1.006
23.353
10.163
0.003
9.473
2.167
41.405
245
agents [1,5,8,9].
On the other hand, there are some risk factors that have
246
thesurgery.or.kr
Postoperative ileus
ing it, except for in some certain cases. The study con-
thesurgery.or.kr
247
act treatment for postoperative ileus has not yet been es-
motility.
CONFLICTS OF INTEREST
claim that the results accompanying this study are remarkable. The most significant finding of this study is
that, in postoperative ileus cases, the timing of restoration
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Postoperative ileus
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