Comparing return of bowel function after right versus extended right hemicolectomy: a retrospective analysis

Area of Science:

• Colorectal surgery
• Surgical outcomes
• Gastrointestinal recovery

Background:

• Prolonged postoperative ileus (PPOI) increases morbidity and hospital stay.
• PPOI is noted to be more frequent after right-sided resections.
• Comparison of bowel function recovery after extended right hemicolectomy (ERH) versus right hemicolectomy (RH) remains unclear.

Purpose of the Study:

• To compare the recovery of patients undergoing ERH and RH.
• To analyze rates of PPOI, return of bowel function, and complications.
• To identify factors influencing PPOI in these patient groups.

Main Methods:

• Retrospective comparison of ERH and RH patients from 2012-2021.
• Analysis of PPOI rates, bowel function return, and postoperative complications.
• Inclusion of 293 patients (42 ERH, 251 RH).

Main Results:

• PPOI was more frequent in ERH (43%) vs. RH (25%) (P=.02).
• PPOI rates were not significantly different when controlling for operative approach (open ERH vs. open RH).
• No difference in bowel function return (excluding PPOI); ERH patients had longer stays and greater Hb drop.

Conclusions:

• While ERH shows higher PPOI rates, this difference diminishes when controlling for surgical approach.
• Further research into PPOI, especially after laparoscopic surgery, is needed.
• Tailoring Enhanced Recovery After Surgery (ERAS) protocols based on surgical approach is recommended.