Langenbeck's Archives of Surgery

, Volume 383, Issue 1, pp 49–55

Laparoscopic versus conventional colorectal resection: a prospective randomised study of postoperative ileus and early postoperative feeding

  • W. Schwenk
  • B. Böhm
  • O. Haase
  • T. Junghans
  • J. M. Müller
ORIGINAL ARTICLE

DOI: 10.1007/s004230050091

Cite this article as:
Schwenk, W., Böhm, B., Haase, O. et al. Langenbeck's Arch Surg (1998) 383: 49. doi:10.1007/s004230050091

Abstract

Background: A shorter duration of postoperative ileus and earlier oral alimentation of patients may be a clinically relevant benefit of laparoscopic compared with conventional colorectal resection. Patients/Methods: A total of 60 patients were randomised to either laparoscopic (n=30) or conventional (n=30) resection of colorectal tumours. Major endpoints were the postoperative time to the first bowel movement and the time until oral feeding without parenteral alimentation was tolerated. Minor endpoints were the postoperative interval to the first peristalsis and first passage of flatus, the distribution of radio-opaque markers in abdominal radiographs on day 3 and day 5 and the incidence of postoperative vomiting. Results: Age, gender, ASA-classification and type of resection were comparable in thetwo groups. Peristalsis was first noticed 26±9 h after laparoscopic and 38±17 h after conventional colorectal resection (P<0.01). First flatus occurred 50±19 h after laparoscopic and 79±21 h after conventional surgery (P<0.01). The incidence of postoperative vomiting was similar in both groups. Three days after surgery radio-opaque markers were found more often in the right colon (P<0.01) and less often in the small intestine (P<0.05) in laparoscopic compared with conventional patients. Five days after laparoscopic surgery, more markers had reached the left colon (P<0.05). The first bowel movement occurred 70±32 h after laparoscopic and 91±22 h after conventional resection (P<0.01). Oral feeding without additional parenteral alimentation was tolerated 3.3±0.7 days after laparoscopic and 5.0±1.5 days after conventional surgery (P<0.01). Conclusion: The shorter duration of postoperative ileus allows earlier restoration of oral feeding after laparoscopic compared with conventional colorectal resection and therefore increases quality of life immediately after resection of colorectal tumours.

Key words Colorectal resectionLaparoscopic surgeryPostoperative ileusEarly postoperative feeding

Copyright information

© Springer-Verlag Berlin Heidelberg 1998

Authors and Affiliations

  • W. Schwenk
    • 1
  • B. Böhm
    • 1
  • O. Haase
    • 1
  • T. Junghans
    • 1
  • J. M. Müller
    • 1
  1. 1.Department of Surgery, Medical Faculty of the Humboldt-University at Berlin, Charité, GermanyDE
  2. 2.Universitätsklinik und Poliklinik für Chirurgie, Medizinische Fakultät der Humboldt-Universität zu Berlin, Charité, Schumannstrasse 20/21, D-10117 Berlin, Germany Tel.: +49 030 2802 5048; Fax: +49 030 2802 1175DE