Methods for decreasing postoperative gut dysmotility

Lancet Oncol. 2003 Jun;4(6):365-72. doi: 10.1016/s1470-2045(03)01118-5.

Abstract

Postoperative disturbances of gastrointestinal function (postoperative ileus) are among the most significant side-effects of abdominal surgery for cancer. Without specific treatment, major abdominal surgery causes a predictable gastrointestinal dysfunction which endures for 4-5 days and results in an average hospital stay of 7-8 days. Ileus occurs because of initially absent and subsequently abnormal motor function of the stomach, small bowel, and colon. This disruption results in delayed transit of gastrointestinal content, intolerance of food, and gas retention. The aetiology of ileus is multifactorial, and includes autonomic neural dysfunction, inflammatory mediators, narcotics, gastrointestinal hormone disruptions, and anaesthetics. In the past, treatment has consisted of nasogastric suction, intravenous fluids, correction of electrolyte abnormalities, and observation. Currently, the most effective treatment is a multimodal approach. Median stays of 2-3 days after removal of all or part of the colon (colectomy) are now achievable. Recent discoveries have the potential to significantly reduce postoperative ileus in patients with cancer who have had abdominal surgery.

Publication types

  • Review

MeSH terms

  • Abdomen / surgery*
  • Autonomic Nervous System / physiology
  • Combined Modality Therapy
  • Gastrointestinal Hormones / physiology
  • Gastrointestinal Hormones / therapeutic use
  • Gastrointestinal Motility / drug effects
  • Gastrointestinal Motility / immunology
  • Gastrointestinal Motility / physiology*
  • Humans
  • Intestinal Obstruction / drug therapy
  • Intestinal Obstruction / etiology
  • Intestinal Obstruction / therapy*
  • Narcotics / adverse effects
  • Parasympatholytics / therapeutic use
  • Postoperative Complications / drug therapy
  • Postoperative Complications / etiology
  • Postoperative Complications / therapy*
  • Sympatholytics / therapeutic use

Substances

  • Gastrointestinal Hormones
  • Narcotics
  • Parasympatholytics
  • Sympatholytics