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A standardized postoperative bowel regimen protocol after spine surgery
OBJECTIVES: Spine surgery is associated with early impairment of gastrointestinal motility, with postoperative ileus rates of 5–12%. A standardized postoperative medication regimen aimed at early restoration of bowel function can reduce morbidity and cost, and its study should be prioritized. METHOD...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10063852/ https://www.ncbi.nlm.nih.gov/pubmed/37009608 http://dx.doi.org/10.3389/fsurg.2023.1130223 |
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author | Yue, John K. Krishnan, Nishanth Wang, Albert S. Chung, Jason E. Etemad, Leila L. Manley, Geoffrey T. Tarapore, Phiroz E. |
author_facet | Yue, John K. Krishnan, Nishanth Wang, Albert S. Chung, Jason E. Etemad, Leila L. Manley, Geoffrey T. Tarapore, Phiroz E. |
author_sort | Yue, John K. |
collection | PubMed |
description | OBJECTIVES: Spine surgery is associated with early impairment of gastrointestinal motility, with postoperative ileus rates of 5–12%. A standardized postoperative medication regimen aimed at early restoration of bowel function can reduce morbidity and cost, and its study should be prioritized. METHODS: A standardized postoperative bowel medication protocol was implemented for all elective spine surgeries performed by a single neurosurgeon from March 1, 2022 to June 30, 2022 at a metropolitan Veterans Affairs medical center. Daily bowel function was tracked and medications were advanced using the protocol. Clinical, surgical, and length of stay data are reported. RESULTS: Across 20 consecutive surgeries in 19 patients, mean age was 68.9 years [standard deviation (SD) = 10; range 40–84]. Seventy-four percent reported preoperative constipation. Surgeries consisted of 45% fusion and 55% decompression; lumbar retroperitoneal approaches constituted 30% (10% anterior, 20% lateral). Two patients were discharged in good condition prior to bowel movement after meeting institutional discharge criteria; the other 18 cases all had return of bowel function by postoperative day (POD) 3 (mean = 1.8-days, SD = 0.7). There were no inpatient or 30-day complications. Mean discharge occurred 3.3-days post-surgery (SD = 1.5; range 1–6; home 95%, skilled nursing facility 5%). Estimated cumulative cost of the bowel regimen was $17 on POD 3. CONCLUSIONS: Careful monitoring of return of bowel function after elective spine surgery is important for preventing ileus, reducing healthcare cost, and ensuring quality. Our standardized postoperative bowel regimen was associated with return of bowel function within 3 days and low costs. These findings can be utilized in quality-of-care pathways. |
format | Online Article Text |
id | pubmed-10063852 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-100638522023-04-01 A standardized postoperative bowel regimen protocol after spine surgery Yue, John K. Krishnan, Nishanth Wang, Albert S. Chung, Jason E. Etemad, Leila L. Manley, Geoffrey T. Tarapore, Phiroz E. Front Surg Surgery OBJECTIVES: Spine surgery is associated with early impairment of gastrointestinal motility, with postoperative ileus rates of 5–12%. A standardized postoperative medication regimen aimed at early restoration of bowel function can reduce morbidity and cost, and its study should be prioritized. METHODS: A standardized postoperative bowel medication protocol was implemented for all elective spine surgeries performed by a single neurosurgeon from March 1, 2022 to June 30, 2022 at a metropolitan Veterans Affairs medical center. Daily bowel function was tracked and medications were advanced using the protocol. Clinical, surgical, and length of stay data are reported. RESULTS: Across 20 consecutive surgeries in 19 patients, mean age was 68.9 years [standard deviation (SD) = 10; range 40–84]. Seventy-four percent reported preoperative constipation. Surgeries consisted of 45% fusion and 55% decompression; lumbar retroperitoneal approaches constituted 30% (10% anterior, 20% lateral). Two patients were discharged in good condition prior to bowel movement after meeting institutional discharge criteria; the other 18 cases all had return of bowel function by postoperative day (POD) 3 (mean = 1.8-days, SD = 0.7). There were no inpatient or 30-day complications. Mean discharge occurred 3.3-days post-surgery (SD = 1.5; range 1–6; home 95%, skilled nursing facility 5%). Estimated cumulative cost of the bowel regimen was $17 on POD 3. CONCLUSIONS: Careful monitoring of return of bowel function after elective spine surgery is important for preventing ileus, reducing healthcare cost, and ensuring quality. Our standardized postoperative bowel regimen was associated with return of bowel function within 3 days and low costs. These findings can be utilized in quality-of-care pathways. Frontiers Media S.A. 2023-03-17 /pmc/articles/PMC10063852/ /pubmed/37009608 http://dx.doi.org/10.3389/fsurg.2023.1130223 Text en © 2023 Yue, Krishnan, Wang, Chung, Etemad, Manley and Tarapore. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Surgery Yue, John K. Krishnan, Nishanth Wang, Albert S. Chung, Jason E. Etemad, Leila L. Manley, Geoffrey T. Tarapore, Phiroz E. A standardized postoperative bowel regimen protocol after spine surgery |
title | A standardized postoperative bowel regimen protocol after spine surgery |
title_full | A standardized postoperative bowel regimen protocol after spine surgery |
title_fullStr | A standardized postoperative bowel regimen protocol after spine surgery |
title_full_unstemmed | A standardized postoperative bowel regimen protocol after spine surgery |
title_short | A standardized postoperative bowel regimen protocol after spine surgery |
title_sort | standardized postoperative bowel regimen protocol after spine surgery |
topic | Surgery |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10063852/ https://www.ncbi.nlm.nih.gov/pubmed/37009608 http://dx.doi.org/10.3389/fsurg.2023.1130223 |
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