Article

Gastrointestinal transit after laparoscopic versus open colonic resection.

Department of Surgical Gastroenterology, Copenhagen University Hospital, Hvidovre, Denmark.
Surgical Endoscopy (impact factor: 4.01). 12/2003; 17(12):1919-22. DOI:10.1007/s00464-003-9013-0 pp.1919-22
Source: PubMed

ABSTRACT Multimodal rehabilitation with epidural analgesia, early oral nutrition and mobilization, and laxative use has decreased the duration of ileus after colonic surgery to about 2 days, as compared with the usual 3 to 5 days of rehabilitation required after open surgery and the slightly shorter time required with laparoscopic surgery. Gastrointestinal transit after colonic resection with laparoscopy or laparotomy was assessed.
In this study, 32 patients randomized to laparoscopic or open colonic resection received 4 MBq of 111indium diethylenetriamine pentaacetic acid, a tracer, at the end of surgery. Images of the abdomen were obtained 24 and 48 h postoperatively. An opaque abdominal dressing blinded care personnel and patients to the procedure.
Defecation occurred on median day 2 postoperatively in both groups. At 48 h postoperatively, 53% of the tracer was excreted by patients in the laparoscopic group, as compared with 26% in the open group ( p > 0.05).
Postoperative ileus and gastrointestinal transit normalized within 48 h after colonic resection in the patients who received multimodal rehabilitation. No significant difference was observed between the patients who underwent the laparoscopic procedure and those who underwent the open procedure.

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Keywords

111indium diethylenetriamine pentaacetic acid
 
2 days
 
32 patients randomized
 
4 MBq
 
48 h postoperatively
 
5 days
 
care personnel
 
colonic surgery
 
epidural analgesia
 
gastrointestinal transit normalized
 
laparoscopic procedure
 
laparoscopic surgery
 
laxative use
 
median day 2 postoperatively
 
multimodal rehabilitation
 
open colonic resection
 
open procedure
 
open surgery
 
Postoperative ileus
 
usual 3