Postoperative intestinal motility following conventional and laparoscopic intestinal surgery
B. Bohm, J. W. Milsom and V. W. Fazio
Department of Colorectal Surgery, Cleveland, Ohio, USA.
OBJECTIVES: To evaluate the influence of conventional vs laparoscopic
right-sided colectomy on postoperative motility of the stomach, small
bowel, and large bowel, and to study the effects on postoperative
intestinal motility of anesthesia only and of laparotomy vs laparoscopy
only. DESIGN: Prospective randomized study in a canine model. SETTING:
Animal research laboratory. ANIMALS: Twelve mongrel dogs weighting 23.4 to
29.6 kg. INTERVENTIONS: (1) Laparotomy or laparoscopy and (2) 1 week after
complete recovery from the first procedure, right-sided colectomy with
ileocolic anastomosis using conventional or laparoscopic techniques. End
points of the study were (1) the postoperative time until the electrical
response activity of the stomach, small intestine, and large intestine
returned to a normal interdigestive pattern and (2) the time until first
postoperative bowel movement occurred. RESULTS: Median time until return to
normal interdigestive pattern of myoelectrical activity after laparoscopic
colectomy was about 40% less than after conventional colectomy (P <
.05). Time until first bowel movement was 27% reduced (P < .05).
CONCLUSIONS: Recovery from postoperative ileus following laparoscopic
surgery is more rapid than after conventional surgery in the canine model.
Confirmatory human studies should be performed.
