4 cases of ileus due to food residue diagnosed by combination of images and medical history these compared with the operation in Hµ Nam hospital during 1999-2000. The ileus is common emergency in the surgical department. The ileus due to the food residue occurred in all age groups.
Ileus ; Surgery

During 4 years (31/12/1997 - 31/12/2001), the Viet Tiep Hospital has operated 105 cases with postoperative adhesive ileus, 56 males and 49 females, the youngest is 13 years old, the oldest is 83 years old, with a mean age of 42.4. Clinical - X ray signs: stomachache 100%, loss fart 100%, vomit 97.1%, 100% X quang of stomach had steam level, brilliant intestine 33.3%. The therapeutic results: mean period of hospitalization was 11.3 days, mortality 0%, the patients having the time before operation of 15 hours - 24 hours are 50.5%, of > 24 hours are 40,9%
Diagnosis ; Therapeutics ; Ileus ; Surgery

PURPOSE: The purposes of this study are to determine the incidence of postoperative ileus after colorectal surgery, to analyze its clinical features, and to identify the risk factors for its development. METHODS: We reviewed the cases of 263 patients with mechanical ileus among 3,237 patients who underwent colorectal surgery in our clinic between June 1989 and December 2000. RESULTS: A total of 263 (8.1%) patients of postoperative ileus were documented, 193 (73.4%) cases occurred during the 1st. year. Postoperative ileus is influenced by the initial site of surgery; the rectum has more impact than the colon (P=0.028). The causes of postoperative ileus were adhesion, recurrence of cancer, and parastomal hernia. Adhesion (81.1%) was the most common cause of ileus, and cancer recurrence (18.0%) was the second. However, in postoperative ileus requiring surgery, cancer recurrence increased with time (2 year: 58.1%). The cases receiving postoperative adjuvant radiation therapy presented a significant increase in the incidence of postoperative ileus (10.3% vs 6.7% P=0.01) and in the requirement for surgical treatment (4.6% vs 2.7%, P=0.04). Patients with a temporary stoma presented a significant increase in the incidence of postoperative ileus than patients with a permanent stoma (P=0.001). The frequency of prior episodes of ileus was the strongest predictor of recurrence. CONCLUSIONS: There is a high risk of adhesion-related problems after colorectal surgery. The risk factors are associated with rectal surgery, postoperative radiation therapy, and a temporary stoma.
Colon ; Colorectal Surgery* ; Hernia ; Humans ; Ileus ; Incidence ; Intestinal Obstruction* ; Postoperative Complications ; Rectum ; Recurrence ; Risk Factors

PURPOSE: The routine use of postoperative nasogastric decompression after abdominal surgery has been challenged. Furthermore, investigators have recently shown that early postoperative oral feeding is safe and generally well tolerated. This study was aimed to determine whether or not early postoperative feeding is safe after elective colorectal surgery. METHODS: All patients who underwent elective colorectal surgeries between June 1998 and March 1999 were permitted to take oral intake one day after the operations. The patients were compared with other patients, who had underwent elective colorectal surgeries between September 1997 and June 1998 and permitted to have a meal after resolving postoperative ileus. The nasogastric tube was removed from all patients immediately after surgery. The patients were monitored for the time of ileus resolution, nausea/vomiting, abdominal distension, nasogastric tube reinsertion and complications. RESULTS: Fifty-one patients were studied, 24 patients in early feeding group and 27 patients in traditional feeding group. Eighteen patients (75.0%) in the early feeding group tolerated the early oral intake. There were no significant differences between two groups in the time for resolution of ileus (3.46 1.38 days vs 3.56 1.80 days), nausea/vomiting (33.3% vs 29.6%), abdominal distension (16.6% vs 14.8%) and nasogastric tube reinsertion (12.5% vs 7.4%). No significant difference was noted in complications such as wound infection, pulmonary problems, intestinal obstruction and anastomotic leak. CONCLUSIONS: Early oral intake after elective colorectal surgery was safe and most of the patients tolerated it. And it may become a kind of managements after elective colorectal surgery.
Anastomotic Leak ; Colorectal Surgery* ; Decompression ; Humans ; Ileus ; Intestinal Obstruction ; Meals ; Research Personnel ; Wound Infection

OBJECTIVETo compare the incidence of postoperative ileus following laparoscopic and open radical resection for colorectal cancer using meta-analysis.

METHODSThe Cochrane library, Pubmed, Ovid databases were searched as of October 2011. Two reviewers extracted the data and assessed the methodological quality independently. The homogeneity of studies was evaluated and the meta-analysis was conducted by the Cochrane Collaboration RevMan 5.0 software.

RESULTSSeven studies including 3630 cases were analyzed. A total of 1814 patients received laparoscopic surgery, of whom 58 developed postoperative ileus. There were 1816 cases undergoing open surgery, of whom 105 developed early postoperative ileus. The pooled relative risk was 0.55 with a 95% confidence interval of 0.41-0.76. The difference was statistically significant(P<0.01).

CONCLUSIONCompared with open surgery, laparoscopic colorectal resection can reduce the incidence of postoperative ileus.

Colectomy ; Colorectal Neoplasms ; surgery ; Humans ; Ileus ; epidemiology ; etiology ; Incidence ; Laparoscopy ; Postoperative Complications

Introduction: Several investigators demonstrated that routine nasogastric decompression after abdominal surgery was unnecessary and can be safely eliminated. Some authors suggested that early feeding could be tolerated by the majority of patients after elective colorectal surgery. PURPOSE: The aim of our study was to prospectively assess the safety and tolerability of early oral feeding after colorectal surgery. METHODS: This trial included 69 patients who underwent an colon or rectal operation between April 1997 and August 1998. Patients were randomized after the operative procedure into one of two groups. Group 1: early oral feeding-all patents received a clear liquid diet on the first postoperative day followed by a regular diet as tolerated. Group 2: delayed feeding-all patients were treated in the traditional way with feeding only after the resolution of their postoperative ileus. Both groups had intraoperative nasogastric tubes that were removed at the end of surgery. The patients were monitored for vomiting, nasogastric tube reinsertion, time of regular diet consumption, complication, and length of hospitalization. The nasogastric tube was reinserted if two or more episodes of vomiting of more than 100 ml occurred in the absence of bowel movement. RESULTS: Sixty-nine consecutive patients were studied, 34 patients in group 1 (12 males and 22 females, mean age 58.1+/-12.7), and 35 patients in group 2 (16 males and 19 females, mean age 58.5+/-12.7). Significant differences were not noted in age and type of procedures. No significant differences were seen in rates of vomiting and overall complications. However, early feeding group well tolerated a regular diet (postoperative period to take regular diet of group 1: 5.4+/-4.0 days, group 2 : 8.1+/-4.6 days, p=0.013), and were discharged from hospital significantly earlier than the delayed feeding group(group 1: 14.0+/-5.1 days, group 2: 19.1+/-8.6 days, p=0.004). CONCLUSION: Early feeding after colorectal surgery is successfully tolerated by the majority of patients and led to earlier hospital discharge.
Colon ; Colorectal Surgery* ; Decompression ; Diet ; Female ; Hospitalization ; Humans ; Ileus ; Male ; Prospective Studies ; Research Personnel ; Surgical Procedures, Operative ; Vomiting

Use of laparoscopic appendectomy (LA) for perforated appendicitis (PA) in children remains controversial because of the development of postoperative intra-abdominal abscess formation. We developed the irrigation method for the prevention of abscess formation after LA performed for PA in children with severe panperitonitis. We called it 'the shaking irrigation'. The object of this study was to analyze the efficacy of this irrigation method. All cases of PA with severe panperitonitis in children that underwent LA with massive shaking irrigation and drainage between June 2003 and December 2007 were studied retrospectively. We included only PA with panperitonitis and large amounts of purulent ascites throughout the abdomen as well as an inflamed small bowel with ileus. Thirty-four children were involved in this study. The mean patient age was eight years. The mean amount of irrigation fluid was 8.2L (range: 4-15L). The mean operative time was 89.5 min. The mean length of the hospital stay was 5.1 days. There were no postoperative intra-abdominal abscesses. There was no conversion to open surgery. In conclusion, Use of LA in PA with severe panperitonitis in children is safe and effective. Massive shaking irrigation and abdominal drainage appears to prevent intra-abdominal abscesses after LA for PA with panperitonitis.
Abdomen ; Abdominal Abscess ; Abscess ; Appendectomy ; Appendicitis ; Ascites ; Child ; Conversion to Open Surgery ; Drainage ; Humans ; Ileus ; Length of Stay ; Operative Time ; Retrospective Studies

PURPOSE: This study was performed to assess the complications and discomfort of patients with or without a nasogastric tube who underwent elective colorectal surgery and to evaluate the efficacy of the routine practice of employing a nasogastric tube after elective colorectal surgery. METHODS: This study involved a prospective, randomized trial of 100 patients undergoing elective colorectal surgery from February to July 2004. The patients were classified as the nasogastric tube inserted group (NG (+), n=50) and non-inserted group (NG (-), n=50). The inclusion criteria were elective colorectal surgery, age under 70 years and no previous abdominal surgery history. The exclusion criteria were an emergent operation, an overt preoperative bowel obstruction and extensive operations such as pouch surgery and multivisceral resection. RESULTS: The mean age of the subjects was 55 (24~70) years old. There was no difference in terms of age, gender, pathological diagnosis and surgical procedures between the NG (-) and NG (+) groups. A sore throat and nausea was more prevalent in the NG (+) group (P=0.000, P=0.046). The gas passage time was shorter in the NG (-) group than in the NG (+) group (P=0.028). The other variables, such as vomiting, postoperative ileus, postoperative fever, posto-perative atelectasis, postoperative leakage, intraoperativedecompression, stool passage time and the length of the hospital stay revealed no difference between the groups. CONCLUSION: Nasogastric intubation is an uncomfortable procedure for patients and offers no benefit in preventing postoperatve complications. The routine use of a nasogastric tube is not necessary in elective colorectal surgery.
Colorectal Surgery* ; Diagnosis ; Fever ; Humans ; Ileus ; Intubation, Gastrointestinal* ; Length of Stay ; Nausea ; Pharyngitis ; Postoperative Nausea and Vomiting ; Prospective Studies* ; Pulmonary Atelectasis

OBJECTIVETo explore the safety and feasibility of the combined medial and caudal approach in laparoscopic D3 lymphadenectomy plus complete mesocolic excision(CME) for right hemicolectomy in the treatment of right hemicolon cancer complicated with incomplete ileus.

METHODSClinical data of 65 patients with incomplete obstructive right-sided colon cancer (T1 to 4M0) diagnosed by abdominal CT enhanced scan or MRI and/or electric colonscope undergoing laparoscopic right hemicolectomy (D3 lymphadenectomy + CME) at Department of Emergency Medicine and Department of Gastrointestinal Surgery from June 2014 to June 2017 were retrospectively analyzed. Among them, 33 patients received the combined medial and caudal approach (combined medial and caudal approach group) and the other 32 patients received the cephalo medial-to-lateral approach (cephalo medial-to-lateral approach group). The operation highlights of the combined medial and caudal approach group were as follows: (1) The superior mesenteric vein (SMV) was first identified and exposed using the combined medial and caudal approach, and lymph node dissection along the anterior and right of SMV was performed. (2) With horizontal part of duodenum as landmarks, the dorsal mesenteric membrane of terminal ileum was opened by caudal-to-cranial approach, and right retroperitoneal space along the Toldt's space was separated. The anterior of pancreatic head and the right Toldt's space were then exposed. (3) Finally using medial-to-lateral approach, the roots of ileocolic vessels, middle colic vessel and right colic vessel were disconnected and ligated along the left border of SMV. The right branch of gastrocolic trunk of Henle was ligated and lymph node dissection along SMV was performed again. Patients in cephalo medial-to-lateral approach group underwent conventional operation. Baseline information, intraoperative blood loss, operation time, number of harvested lymph nodes, proportion of no less than 12 harvested lymph nodes per case, postoperative hospital stay and postoperative morbidity in both groups were analyzed and compared.

RESULTSThirty-eight males and 27 females with age of 31 to 72 (56.8±11.7) years were enrolled in this study. There was no significant difference in baseline information between combined medial and caudal approach group and cephalo medial-to-lateral approach group(all P>0.05). Intraoperative blood loss [(106.5±24.5) ml vs. (308.4±27.1) ml, t=-31.501, P=0.000] was significantly less, and operative time [(176.3 ± 18.0) minutes vs. (208.4 ± 47.3) minutes, t=-3.602, P=0.001] was significantly shorter in the combined medial and caudal approach group. The proportion of no less than 2 harvested lymph nodes per case [87.9%(29/33) vs. 84.4%(27/32)], the number of harvested lymph nodes (22.5±8.9 vs. 21.5± 7.6), postoperative morbidity of complication [6.1%(2/33) vs. 12.5%(4/32)] and postoperative hospital stay [(11.9±1.5) days vs. (13.4±4.4) days] were not significantly different between the two groups(all P>0.05).

CONCLUSIONThe combined medial and caudal approach in laparoscopic right hemicolectomy (D3+CME) in the treatment of incomplete obstructive right-sided colon cancer is safe and feasible, and has advantages of less intraoperative blood loss and shorter operation time compared to the cephalo medial-to-lateral approach.

Adult ; Aged ; Colectomy ; Colonic Neoplasms ; surgery ; Female ; Humans ; Ileus ; Laparoscopy ; Lymph Node Excision ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo evaluate the clinical use of endoscopic ileus tube drainage in preoperative therapy for acute low malignant colorectal obstruction.

METHODSFrom Nov. 2004 to Dec. 2005, 15 cases with acute low malignant colorectal obstruction received emergency colonoscopy and endoscopic ileus tube drainage was performed. Radical resection was then performed after seven days of drainage.

RESULTSEndoscopic ileus tube drainage was successful in 13 cases, and failed in 2 cases because the guide wire cannot be inserted through the tumor in one case, and in the other case the tumor was located in the middle of the transverse colon so that the ileus drainage tube was not long enough. Abdominal girth decreased from (91+/- 4) cm to (82+/- 2) cm after tube drainage. The everyday drainage volume minus rinsing volume ranged from - 600 ml to 3200 ml. Abdominal X ray showed that obstruction was relieved. Intra-operative exploration revealed that colon edema was not evident, which increased resection rate.

CONCLUSIONEndoscopic ileus tube drainage is effective, safe and maybe the first choice of acute low malignant colorectal obstruction.

Acute Disease ; Adult ; Aged ; Aged, 80 and over ; Colorectal Neoplasms ; surgery ; Decompression, Surgical ; methods ; Drainage ; methods ; Female ; Humans ; Ileus ; surgery ; Intestinal Obstruction ; surgery ; Male ; Middle Aged