Recovery of gastric ileus following laparoscopic ventral rectopexy within an enhanced recovery protocol

Surg Today. 2016 Aug;46(8):895-900. doi: 10.1007/s00595-015-1255-7. Epub 2015 Sep 25.

Abstract

Purpose: The enhanced recovery after surgery (ERAS) protocol has had limited adoption in laparoscopic ventral rectopexy (LVR), and the extent of gastric ileus shortly after LVR remains unknown. This study was designed to assess the degree of gastric emptying shortly after LVR within an ERAS protocol.

Methods: From August 2012 to June 2014, 40 patients diagnosed with external or internal rectal prolapse were recruited. All patients underwent LVR within an ERAS protocol. Carbohydrate solution (CS) was administered before and 5 h after surgery on the same day. The pyloric area (PA) was measured using ultrasonography before and after each CS intake.

Results: The PA was measured in 34 patients. The PA measured prior to CS intake, before surgery, was not significantly different from that after surgery. The rate of increase in the PA, which was calculated by the PA measured 1 h after CS intake divided by the PA measured prior to CS intake before surgery, was not significantly different from that after surgery. The postoperative hospital stay was 1 (1-2) day, and 36 patients (90 %) were discharged on the first postoperative afternoon.

Conclusion: Postoperative gastric ileus was resolved in most cases within 5 h after LVR under an ERAS protocol.

Keywords: Enhanced recovery protocol; Gastric ileus; Laparoscopic ventral rectopexy; Pyloric area measurement using ultrasonography.

MeSH terms

  • Carbohydrates / administration & dosage
  • Clinical Protocols*
  • Digestive System Surgical Procedures / methods*
  • Gastric Emptying
  • Humans
  • Ileus / diagnostic imaging
  • Ileus / physiopathology
  • Ileus / prevention & control*
  • Ileus / therapy*
  • Laparoscopy / methods*
  • Length of Stay
  • Postoperative Complications / therapy*
  • Pylorus / diagnostic imaging
  • Pylorus / physiopathology
  • Rectal Prolapse / surgery
  • Solutions
  • Stomach Diseases / diagnostic imaging
  • Stomach Diseases / physiopathology
  • Stomach Diseases / therapy*
  • Time Factors
  • Ultrasonography

Substances

  • Carbohydrates
  • Solutions