Pathogenesis and clinical and economic consequences of postoperative ileus

Anthony J. Senagore

    Research output: Contribution to journalArticle

    80 Scopus citations

    Abstract

    Purpose. The pathogenesis, etiology, clinical manifestations, and clinical and economic consequences of postoperative ileus (POI) in patients undergoing major abdominal surgery; the estimated prevalence of POI; the potential cost savings from efforts to shorten hospital length of stay (LOS); and the role of patient counseling in minimizing the consequences of POI are discussed. Summary. POI has neurogenic, inflammatory, hormonal, and pharmacologic components. It manifests as abdominal distention, pain, nausea, vomiting, and inability to pass stools or tolerate a solid diet that in half of patients undergoing major abdominal surgery persist for more than four days. Surgical stress and prolonged opioid analgesic use contribute to POI. Delayed surgical wound healing and ambulation, atelectasis, pneumonia, and deep vein thrombosis are among the possible complications of POI that can increase LOS, resource use, and health care costs. POI is common; its prevalence probably is underestimated. The potential cost savings from shortening LOS by one day are substantial. Providing advice about the proper preoperative and postoperative care regimen to patients undergoing major abdominal surgery can minimize the clinical and economic consequences of POI. Conclusion. POI is a common complication of major abdominal surgery that can have a substantial clinical and economic impact.

    Original languageEnglish (US)
    Pages (from-to)S3-S7
    JournalAmerican Journal of Health-System Pharmacy
    Volume64
    Issue number20 SUPPL.
    DOIs
    StatePublished - Oct 15 2007

    Keywords

    • Economics
    • Hospitals
    • Ileus
    • Opiates
    • Patient information
    • Postoperative complications
    • Toxicity

    ASJC Scopus subject areas

    • Pharmacology
    • Health Policy

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