Postoperative ileus, a transient cessation of coordinated bowel motility, occurs to some extent after all major abdominal operations.
Dr Bruce Wolff and colleagues from Minnesota, USA assessed 727 patients undergoing partial bowel resection and 140 who underwent total abdominal hysterectomy by laparotomy.
The research team examined gastrointestinal (GI) recovery and hospital discharge history in these patients.
The team conducted a pooled post hoc analysis of placebo groups from randomized, double-blind, parallel-group, multicenter alvimopan trials.
|40% were discharged before GI recovery was complete |
|Journal of the American College of Surgeons|
All patients were uniformly managed with a standardized accelerated postoperative care pathway to facilitate gastrointestinal recovery.
Postoperative ileus as an adverse event was reported in approximately 15% of bowel resection patients, and 3% of total abdominal hysterectomy patients.
The team found that postoperative nasogastric tube insertion was required in 12% of bowel resection patients, and 1% of total abdominal hysterectomy patients.
The researchers noted that time to first toleration of solid food was almost 2 days longer for bowel resection patients than for total abdominal hysterectomy patients.
Approximately 34% of bowel resection patients, and 4% of total abdominal hysterectomy patients had discharge orders written 7 days or more after operation.
About 40% of patients undergoing total abdominal hysterectomy were discharged from the hospital before gastrointestinal recovery was complete.
The team observed that mean postoperative lengths of hospital stay after bowel resection, and total abdominal hysterectomy were 7 days and 3 days, respectively.
Dr Wolff's team concluded, "Despite the relatively fast recovery observed with standardized accelerated postoperative care pathway use, postoperative ileus as an adverse event was still reported in approximately 15% of bowel resection patients, and 3% of total abdominal hysterectomy patients."
"This analysis provides important clinical insight into the differences in gastrointestinal recovery patterns and the incidence and impact of postoperative ileus after bowel resection and total abdominal hysterectomy."