Epidural analgesia and laparoscopic technique do not reduce incidence of prolonged ileus in elective colon resections.
BACKGROUND
This study evaluated the incidence and risk factors for prolonged ileus in patients undergoing elective colon resection.


METHODS
Retrospective data were obtained in patients undergoing open colectomy with or without epidural analgesia and laparoscopic colectomy at a university-affiliated Veterans hospital. The incidence and risk factors of prolonged ileus as defined by no bowel movement before postoperative day 7 or placement of a nasogastric tube because of vomiting or abdominal distension were analyzed.


RESULTS
Incidence of prolonged ileus was 15.2%, 22.4%, and 16.7% in epidural (92 patients), nonepidural (107 patients), and laparoscopic colectomy (48 patients), respectively (P = .39). Higher age, American Society of Anesthesiologists scores, and number of comorbidities, and lower postoperative potassium level were associated with the development of prolonged ileus.


CONCLUSIONS
The incidence of prolonged ileus was similar in the 3 groups studied. However, the epidural and laparoscopic groups experienced earlier return of bowel function and toleration of diet than the nonepidural group.
Department of Surgery, G.V. (Sonny) Montgomery VA Medical Center, Jackson, MS 39216, USA.
Rajesh
R
Kuruba
Nicholas
N
Fayard
David
D
Snyder
D000368:Aged; D015360:Analgesia, Epidural; D003082:Colectomy / Q000379:methods*; D017558:Elective Surgical Procedures / Q000379:methods*; D005260:Female; D006801:Humans; D045823:Ileus / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D015994:Incidence; D010535:Laparoscopy; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D012189:Retrospective Studies; D012307:Risk Factors