State-of-the-art colorectal disease: postoperative ileus.
Int J Colorectal Dis
; 36(9): 2017-2025, 2021 Sep.
Article
em En
| MEDLINE
| ID: mdl-33977334
ABSTRACT
PURPOSE:
Postoperative Ileus (POI) remains an important complication for patients after abdominal surgery with an incidence of 10-27% representing an everyday issue for abdominal surgeons. It accounts for patients' discomfort, increased morbidity, prolonged hospital stays, and a high economic burden. This review outlines the current understanding of POI pathophysiology and focuses on preventive treatments that have proven to be effective or at least show promising effects.METHODS:
Pathophysiology and recommendations for POI treatment are summarized on the basis of a selective literature review.RESULTS:
While a lot of therapies have been researched over the past decades, many of them failed to prove successful in meta-analyses. To date, there is no evidence-based treatment once POI has manifested. In the era of enhanced recovery after surgery or fast track regimes, a few approaches show a beneficial effect in preventing POI multimodal, opioid-sparing analgesia with placement of epidural catheters or transverse abdominis plane block; µ-opioid-receptor antagonists; and goal-directed fluid therapy and in general the use of minimally invasive surgery.CONCLUSION:
The results of different studies are often contradictory, as a concise definition of POI and reliable surrogate endpoints are still absent. These will be needed to advance POI research and provide clinicians with consistent data to improve the treatment strategies.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Neoplasias Colorretais
/
Íleus
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
Alemanha