Editorial
Copyright ©2010 Baishideng. All rights reserved.
World J Gastroenterol. May 7, 2010; 16(17): 2067-2074
Published online May 7, 2010. doi: 10.3748/wjg.v16.i17.2067
Postoperative ileus: Impact of pharmacological treatment, laparoscopic surgery and enhanced recovery pathways
Knut Magne Augestad, Conor P Delaney
Knut Magne Augestad, Conor P Delaney, Division of Colorectal Surgery, University Hospitals Case Medical Center, Cleveland, OH 44106-5047, United States
Knut Magne Augestad, Department of Digestive Surgery, Telemedicine and Integrated Care, University Hospital North Norway, 9037 Tromsø, Norway
Author contributions: Augestad KM wrote the paper; Delaney CP supervised in the writing process, and critically revised the final version.
Supported by North Norwegian Health Authorities Research Fund
Correspondence to: Conor P Delaney, MD, PhD, Division of Colorectal Surgery, University Hospitals Case Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106-5047, United States. conor.delaney@uhhospitals.org
Telephone: +1-216-8448087 Fax: +1-216-8445957
Received: January 20, 2010
Revised: February 26, 2010
Accepted: March 5, 2010
Published online: May 7, 2010
Abstract

Almost all patients develop postoperative ileus (POI) after abdominal surgery. POI represents the single largest factor influencing length of stay (LOS) after bowel resection, and has great implications for patients and resource utilization in health care. New methods to treat and decrease the length of POI are therefore of great importance. During the past decade, a substantial amount of research has been performed evaluating POI, and great progress has been made in our understanding and treatment of POI. Laparoscopic procedures, enhanced recovery pathways and pharmacologic treatment have been introduced. Each factor has substantially contributed to decreasing the length of POI and thus LOS after bowel resection. This editorial outlines resource utilization of POI, normal physiology of gut motility and pathogenesis of POI. Pharmacological treatment, fast track protocols and laparoscopic surgery can each have significant impact on pathways causing POI. The optimal integration of these treatment options continues to be assessed in prospective studies.

Keywords: Postoperative ileus; Pathophysiology; Cost utilization; Pharmacologic treatment; Laparoscopic surgery; Enhanced recovery pathways