Sunday, June 23, 2019

Urine in operative field

Q: 54 year old male is admitted to surgical ICU after a complication in urologic surgery. Patient continues to experience postoperative ileus during the recovery phase. Among all the risk factors, urine in the operating field may contribute to the postoperative development of ileus? (select one)

A) True
B) False


Answer: A

There is a plethora of literature to identify the risk factors for the prolonged postoperative ileus. Few well-known factors include prolonged abdominal or pelvic surgery, open surgery, delayed enteral nutrition or placement of nasogastric tube, development of peritonitis, sepsis or postoperative infectious complications, a requirement of transfusion during surgery, opioid use, peripheral vascular disease, construction of a stoma, lysis of adhesion, disseminated cancer and others. 


In patients who undergo urologic surgery, urine in the operating field may be a contributing factor for a prolonged postoperative ileus.


#surgical-critical-care



Reference:


Mattei A, Birkhaeuser FD, Baermann C, et al. To stent or not to stent perioperatively the ureteroileal anastomosis of ileal orthotopic bladder substitutes and ileal conduits? Results of a prospective randomized trial. J Urol 2008; 179:582.

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