Risk factors for postoperative ileus / 대한외과학회지

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.

Effects of octreotide on healing of mechanical ileus in rats

To investigate the effects of octreotide on mechanical ileus without surgical intervention. This study was organized to investigate the effects of octreotide [Sandostatine one microgram/ml-Sandoz], a long acting analogue of somatostatin, in a mechanical ileus model in Sprague-Dowley rats. The study was performed at Ankara Oncology Hospital, Ankara, Turkey in April 2005. The animals were randomly separated into 3 groups. 1] control group [n:10] 2] ileus group [n:12], and 3] ileus + octreotide group [n:13]. Intraluminal liquid volume, as well as concentrations of sodium, chlorine, calcium, and phosphorous were measured in systemic circulation, proximal, and middle bowel segments. We also evaluated the leukocyte count, and hematocrit levels in all animals. There was no difference in leukocyte count and hematocrit levels. The effects of octreotide in decreasing intestinal liquid volume, and electrolytes were significant. However, these effects were not beneficial on the mortality rates, and intestinal edema [p>0.05]. We believe additional animal studies, and subsequently controlled clinical trials are necessary before using octreotide as a clinical adjunct in the treatment of small bowel obstruction