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Gastrointestinal transit after laparoscopic versus open colonic resection

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Abstract

Background: Multimodal rehabilitation with epidural analgesia, early oral nutrition and mobilization, and laxative use has decreased the duration of ileus after colonic surgery to about 2 days, as compared with the usual 3 to 5 days of rehabilitation required after open surgery and the slightly shorter time required with laparoscopic surgery. Gastrointestinal transit after colonic resection with laparoscopy or laparotomy was assessed. Methods: In this study, 32 patients randomized to laparoscopic or open colonic resection received 4 MBq of 111indium diethylenetriamine pentaacetic acid, a tracer, at the end of surgery. Images of the abdomen were obtained 24 and 48 h postoperatively. An opaque abdominal dressing blinded care personnel and patients to the procedure. Results: Defecation occurred on median day 2 postoperatively in both groups. At 48 h postoperatively, 53% of the tracer was excreted by patients in the laparoscopic group, as compared with 26% in the open group (p > 0.05). Conclusion: Postoperative ileus and gastrointestinal transit normalized within 48 h after colonic resection in the patients who received multimodal rehabilitation. No significant difference was observed between the patients who underwent the laparoscopic procedure and those who underwent the open procedure.

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Authors and Affiliations

  1. Department of Surgical Gastroenterology, Copenhagen University Hospital, Hvidovre, Denmark

    L. Basse, P. Billesbølle, L. Bardram & H. Kehlet

  2. Department of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital, Hvidovre, Denmark

    J. L. Madsen

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  1. L. Basse
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  2. J. L. Madsen
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  3. P. Billesbølle
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  4. L. Bardram
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  5. H. Kehlet
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Correspondence to L. Basse.

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Basse, L., Madsen, J., Billesbølle, P. et al. Gastrointestinal transit after laparoscopic versus open colonic resection . Surg Endosc 17, 1919–1922 (2003). https://doi.org/10.1007/s00464-003-9013-0

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  • DOI: https://doi.org/10.1007/s00464-003-9013-0

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