General Surgery Department, The Third Affiliated Hospital of Guangxi Medical University, Nanning, China.
Hepatobiliary Surgery Department, Guangxi Medical University Cancer Hospital, Nanning, China.
Medicine (Baltimore). 2024 Nov 1;103(44):e40418. doi: 10.1097/MD.0000000000040418.
Postoperative gastrointestinal dysfunction, including temporary nonmechanical suppression of gastrointestinal motility (known as postoperative ileus), occurs in about 10% surgeries of abdominal tumors. Since these complications can prolong hospitalization and affect eating, it is important to understand their risk factors and identify effective interventions to manage or prevent them. The present review comprehensively examined the relevant literature to describe risk factors for postoperative ileus and effective interventions. Risk factors include old age, open surgery, difficulty of surgery, surgery lasting longer than 3 hours, preoperative bowel treatment, infection, and blood transfusion. Factors that protect against postoperative ileus include early enteral nutrition, minimally invasive surgery, and multimodal pain treatment. Interventions that can shorten or prevent such ileus include minimally invasive surgery, early enteral nutrition as well as use of chewing gum, laxatives, and alvimopan. Most of these interventions have been integrated into current guidelines for enhanced recovery of gastrointestinal function after surgery. Future high-quality research is needed in order to clarify our understanding of efficacy and safety.
术后胃肠道功能障碍,包括暂时的非机械性胃肠动力抑制(称为术后肠梗阻),约发生于 10%的腹部肿瘤手术中。由于这些并发症会延长住院时间并影响进食,了解其风险因素并确定有效的干预措施来管理或预防这些并发症非常重要。本综述全面查阅了相关文献,以描述术后肠梗阻的风险因素和有效干预措施。风险因素包括年龄较大、开放性手术、手术难度大、手术持续时间超过 3 小时、术前肠道处理、感染和输血。预防术后肠梗阻的因素包括早期肠内营养、微创手术和多模式疼痛治疗。可缩短或预防此类肠梗阻的干预措施包括微创手术、早期肠内营养以及咀嚼口香糖、泻药和阿片受体激动剂的应用。这些干预措施中的大多数已被纳入术后胃肠道功能恢复的指南中。为了明确这些干预措施的疗效和安全性,未来需要开展高质量的研究。
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