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The effect of smoking on the incidence of post-operative ileus and length of stay in an enhanced recovery program for colorectal surgery

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The effect of smoking on the incidence of post-operative ileus and length of stay in an enhanced recovery program for colorectal surgery

 

AUTHORS Jichi T, Marshall M, Burt C

 

North Bristol NHS TRUST

 

ABSTRACT TOPIC

Perioperative Care/Nutrition

 

 

AIM

To compare the incidence of post-operative ileus and length of stay in smokers and non-smokers undergoing elective colorectal resection in an enhanced recovery program (ERP).

 

Anecdotally, surgeons see dedicated smokers mobilizing early post operatively. Combined with the prokinetic properties of nicotine, this may decrease ileus in smokers and promote early discharge. However, smoking increases risk of complications that may delay discharge. The aim was to investigate the impact of these conflicting factors on the incidence of post-operative ileus and length of stay.

 

METHOD

A retrospective notes review of 25 patients undergoing elective colorectal resections between September 2016 and July 2017. Clinical presence of ileus, as determined by a consultant surgeon, and length of stay were compared in smokers and non-smokers. Patients aged between 30-65 years old with a BMI of less than 30 were selected to exclude other factors limiting mobility.

 

RESULTS

 

 

Smokers n=10

Non-smokers n=15

P value

Post op ileus n (%)

1 (10)

5 (33)

0.345*

Length of stay median (range)

5 (3-12)

3 (1-14)

0.067ł

 

 

*Fisher exact test

łMann-Whitney U test

 

 

CONCLUSION

  • No statistical difference in incidence of post-operative ileus between smokers and non-smokers. 
  • Overall, smoking delayed discharge.
  • Advice to stop smoking should continue.

 

 

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