Epidural analgesia and laparoscopic technique do not reduce incidence of prolonged ileus in elective colon resections.

Background: This study evaluated the incidence and risk factors for prolonged ileus in patients undergoing elective colon resection.

Methods: Retrospective data were obtained in patients undergoing open colectomy with or without epidural analgesia and laparoscopic colectomy at a university-affiliated Veterans hospital. The incidence and risk factors of prolonged ileus as defined by no bowel movement before postoperative day 7 or placement of a nasogastric tube because of vomiting or abdominal distension were analyzed.

Results: Incidence of prolonged ileus was 15.2%, 22.4%, and 16.7% in epidural (92 patients), nonepidural (107 patients), and laparoscopic colectomy (48 patients), respectively (P = .39). Higher age, American Society of Anesthesiologists scores, and number of comorbidities, and lower postoperative potassium level were associated with the development of prolonged ileus.

Conclusions: The incidence of prolonged ileus was similar in the 3 groups studied. However, the epidural and laparoscopic groups experienced earlier return of bowel function and toleration of diet than the nonepidural group.