From the Guidelines
Recovery after intestinal resection surgery should begin with early oral nutrition, as it leads to significantly shortened hospital length of stay and improved outcomes, including reduced mortality and complications, as evidenced by a Cochrane Systematic Review 1. The recovery process after intestinal resection surgery involves several key steps to ensure a smooth and safe healing process.
- Rest and gradually increase activity over the first 2-3 weeks to avoid putting excessive strain on the abdominal muscles and the surgical site.
- Take prescribed pain medications as directed, usually opioids for severe pain and acetaminophen for mild pain, to manage postoperative pain effectively.
- Follow a balanced hospital diet and/or oral nutritional supplements (ONS) immediately after surgery, as early oral nutrition has been shown to be beneficial in shortening hospital length of stay and reducing complications 1.
- Stay hydrated and take stool softeners to prevent constipation, which can put additional stress on the healing intestine.
- Care for the incision by keeping it clean and dry; watch for signs of infection, such as redness, swelling, or increased pain, and report any concerns to the surgeon promptly.
- Attend follow-up appointments with the surgeon to monitor the healing process and address any potential issues early.
- Avoid heavy lifting (over 10 pounds) for 6-8 weeks to prevent straining the abdominal muscles and disrupting the surgical site.
- Resume normal activities, including work, as advised by the doctor (usually after 4-6 weeks), to ensure a gradual return to full functionality. It is essential to note that the benefits of early oral nutrition have been most clearly demonstrated in patients undergoing colorectal surgery, and the evidence is less clear for patients undergoing upper gastrointestinal and pancreatic surgery, particularly in the elderly 1.
- The amount of initial oral intake should be adapted to the state of gastrointestinal function and to individual tolerance, as impaired tolerance to early oral intake can lead to complications such as nausea, vomiting, and intestinal obstruction 1. By following these guidelines and prioritizing early oral nutrition, patients can minimize the risk of complications and ensure a smooth recovery after intestinal resection surgery.
From the Research
Recovery Process After Intestinal Resection Surgery
The recovery process after intestinal resection (bowel resection) surgery involves a range of factors and techniques to facilitate faster restoration of gastrointestinal function. Some key aspects of the recovery process include:
- The use of opioid-sparing techniques and pharmacologic agents, such as opioid receptor antagonists, to reduce the opioid component of delayed gastrointestinal recovery 2
- The implementation of Enhanced Recovery After Surgery (ERAS) protocols, which are multimodal perioperative care pathways designed to help patients achieve early recovery after surgical procedures 3
- The use of alvimopan, a peripherally acting mu-opioid receptor antagonist, to favorably reduce various outcome measures such as the length of stay and time from surgery to hospital discharge following partial-bowel, large-bowel, or small-bowel resection surgery 4, 5
Factors Influencing Recovery
Several factors can influence the recovery process after intestinal resection surgery, including:
- The type of surgery, with laparoscopic surgery associated with shorter length of stay compared to open surgery 6
- Patient participation in recovery protocols, such as ambulation, which can reduce length of stay 6
- The presence of comorbidities, such as COPD or insulin-dependent diabetes mellitus, which can increase length of stay 6
- The use of patient-controlled analgesia and morphine equivalents, which can increase length of stay 6
- The development of complications, which can significantly increase length of stay 6
Techniques to Enhance Recovery
Several techniques can be used to enhance recovery after intestinal resection surgery, including: