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A survey of perceptions and attitudes among European surgeons towards the clinical impact and management of postoperative ileus


Professor H. Kehlet, Section for Surgical Pathophysiology The Juliane Marie Centre 4074 Rigshospitalet Blegdamsvej 92100 Copenhagen Denmark.


Objective  Postoperative ileus (POI) can negatively affect patient recovery and morbidity, yet the lack of an internationally accepted definition and clinical management pathway for this condition suggest POI may be under-recognized as a clinical problem. The purpose of this survey was therefore to assess current attitudes of surgeons towards the clinical impact and management of POI.

Subjects and methods  Telephone interviews were conducted with 230 surgeons from hospitals in the UK, France, Germany, Italy and Spain.

Results  Across Europe, there are differences in the terms surgeons use to refer to delayed recovery of gastrointestinal (GI) function and the symptoms, concerns and risks they associate with this condition. Furthermore, there is marked variation in the attitudes of European surgeons towards minimizing the risk of delayed recovery of GI function and in the strategies to manage POI. Additionally, some of the measures applied most commonly by European surgeons are in contrast to evidence in the literature indicating that they have no benefit for quicker resolution of GI function.

Conclusion  The results suggest that there is a need for clearer definition of the factors that constitute POI, increased recognition of the impact of this condition and improved understanding of the most effective peri-/postoperative care for surgical patients.