| Postoperative ileus: a review. | |
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MedLine Citation:
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PMID: 14978625 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: Postoperatively, some patients experience a prolonged inhibition of coordinated bowel activity, which causes accumulation of secretions and gas, resulting in nausea, vomiting, abdominal distension, and pain. This prolonged inhibition can take days or weeks to resolve and often is referred to as postoperative paralytic ileus lasting more than three days after surgery. This article reviews the etiology, pathophysiology, and treatment options of postoperative ileus. METHODS: The relevant literature from 1965 to 2003 was identified and reviewed using MEDLINE database of the U.S. Medical Library of Medicine. Both retrospective and prospective studies were included in this review. RESULTS: The pathophysiology of postoperative ileus is multifactorial. The duration of postoperative ileus correlates with the degree of surgical trauma and is most extensive after colonic surgery. However, postoperative ileus can develop after all types of surgery including extraperitoneal surgery. A variety of treatment options have been used to decrease the duration of postoperative ileus. However, it is difficult to compare these studies because of small sample sizes and differences in operations performed, anesthesia protocols provided both intraoperatively and postoperatively, patient comorbidities, and in the measured end points, such as the time to the presence of bowel sounds, flatus, or bowel movements, tolerance of solid food, or discharge from the hospital. However, despite these drawbacks, some conclusions can be made. CONCLUSIONS: Paralytic postoperative ileus continues to be a significant problem after abdominal and other types of surgery. The etiology is multifactorial and is best treated with a combination of different approaches. Currently, the important factors that could effect the duration and recovery from postoperative ileus include limitation of narcotic use by substituting alternative medications such as nonsteroidals and placing a thoracic epidural with local anesthetic when possible. The selective use of nasogastric decompression and correction of electrolyte imbalances also are important factors to consider. |
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Authors:
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Mirza K Baig; Steven D Wexner |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't; Retracted Publication; Review Date: 2004-02-25 |
Journal Detail:
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Title: Diseases of the colon and rectum Volume: 47 ISSN: 0012-3706 ISO Abbreviation: Dis. Colon Rectum Publication Date: 2004 Apr |
Date Detail:
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Created Date: 2004-03-30 Completed Date: 2004-04-21 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0372764 Medline TA: Dis Colon Rectum Country: United States |
Other Details:
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Languages: eng Pagination: 516-26 Citation Subset: IM |
Affiliation:
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Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, Florida 33331, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Anesthesia, Local Digestive System Surgical Procedures / adverse effects* Electrolytes Gastrointestinal Motility Humans Intestinal Pseudo-Obstruction* / etiology, physiopathology, therapy Narcotics / adverse effects, therapeutic use Postoperative Complications* Risk Factors Severity of Illness Index |
| Chemical | |
Reg. No./Substance:
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0/Electrolytes; 0/Narcotics |
| Comments/Corrections | |
Retraction In:
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Dis Colon Rectum. 2005 Oct;48(10):1983
[PMID:
16132475
]
Wexner SD. Dis Colon Rectum. 2005 Oct;48(10):1983 [PMID: 16132474 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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