[Immunomodulatory aspects in the development, prophylaxis and therapy for postoperative ileus]

Area of Science:

• Gastroenterology
• Immunology
• Surgical Complications

Context:

• Postoperative ileus (POI) significantly increases patient morbidity and healthcare costs.
• POI results from impaired gastrointestinal motility following abdominal surgery.
• The condition affects the effective transit of intestinal contents and oral intake tolerance.

Purpose:

• To provide an overview of the immunological mechanisms underlying POI.
• To focus on current and future therapeutic and prophylactic strategies for POI.
• To highlight the limitations of existing POI treatments.

Summary:

• POI is a multifactorial complication involving impaired gut motility.
• Surgical trauma activates macrophages, releasing proinflammatory mediators and causing inflammation.
• Current treatments like prokinetics have shown limited benefit in randomized trials.

Impact:

• Understanding POI's immunological basis is crucial for developing effective interventions.
• Immunoregulatory approaches offer a promising avenue for POI prevention and treatment.
• This review guides future research towards novel therapeutic and prophylactic strategies.