Postoperative ileus: Pathophysiology & treatment strategies

Patients undergoing an abdominal surgical procedure develop a transient episode of impaired gastrointestinal motility, or postoperative ileus. Postoperative ileus, remains an almost inevitable consequence of surgery. Importantly, postoperative ileus is a major determinant of recovery after intestinal surgery and leads to increased morbidity and prolonged hospitalization. The aetiology of postoperative ileus is multifactorial, but activation of a local inflammatory response within the intestinal muscularis has become an accepted pathophysiological mechanism. Although a variety of strategies reduce postoperative ileus, none of these methods have been completely successful in shortening its duration. This thesis consist of a series of investigations into the mechanisms behind postoperative ileus and highlight new strategies to intervene in the postoperative inflammatory cascade and prevent postoperative ileus.