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Shorter postoperative atony after laparoscopic-assisted colonic resection? An animal study
A Tittel1, E Schippers, M Anurov
1Department of Surgery, Medical Faculty of the RWTH Aachen, Pauwelsstrasse 30, 52057 Aachen, Germany. andreas.tittel@post.rwth-aachen.de
Background:
The duration of the postoperative ileus after laparoscopic surgery remains a controversial topic. The aim of our study was to compare the restoration of intestinal motility after laparoscopically assisted and conventional resection of the distal colon in a canine model.
Methods:
Two weeks after the implantation of three electrodes on the jejunum, the distal colon was resected in a laparoscopic-assisted or conventional procedure in two groups of four dogs each. Gastrointestinal motility was monitored by registration of the electromyograhic activity of the small intestine and by intermittent fluoroscopies of radiopaque markers.
Results:
Electrical activity in the early postoperative period was characterized by the basic electrical rhythm and the absence of spike activity. The first postoperative activity front of the migrating motility complex (MMC), indicating the restoration of motility, occurred significantly earlier after laparoscopic-assisted resection (4.5 +/- 1 hr) than after conventional resection (31 +/- 10 h). Radiological observations showed a significantly delayed gastric emptying and a prolonged transit of radiopaque markers to the rectum after open surgery.
Conclusion:
These results support the hypothesis that laparoscopic-assisted resection of the colon leads to a shortened postoperative atony in comparison to open surgery.