Epidural analgesia and laparoscopic technique do not reduce incidence of prolonged ileus in elective colon resections

BackgroundThis study evaluated the incidence and risk factors for prolonged ileus in patients undergoing elective colon resection.MethodsRetrospective data were obtained in patients undergoing open colectomy with or without epidural analgesia and laparoscopic colectomy at a university-affiliated Veterans hospital. The incidence and risk factors of prolonged ileus as defined by no bowel movement before postoperative day 7 or placement of a nasogastric tube because of vomiting or abdominal distension were analyzed.ResultsIncidence of prolonged ileus was 15.2%, 22.4%, and 16.7% in epidural (92 patients), nonepidural (107 patients), and laparoscopic colectomy (48 patients), respectively (P = .39). Higher age, American Society of Anesthesiologists scores, and number of comorbidities, and lower postoperative potassium level were associated with the development of prolonged ileus.ConclusionsThe incidence of prolonged ileus was similar in the 3 groups studied. However, the epidural and laparoscopic groups experienced earlier return of bowel function and toleration of diet than the nonepidural group.