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Minimal Invasive Urologic Surgery and Postoperative Ileus | Abstract
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Minimal Invasive Urologic Surgery and Postoperative Ileus

Author(s): Fouad Aoun,Marc Zanaty,Alexandre Peltier,and Rolandvan Velthoven

Postoperative ileus (POI) is the most common cause of prolonged length of hospital stays (LOS) and associated healthcarecosts.Theadventofminimalinvasivetechniquewasamajorbreakthroughintheurologiclandscapewithgreatpotential toprogressinthefuture.Inthefieldofgastrointestinalsurgery,severalstudieshadreportedlowerincidenceratesforPOIfollowing minimalinvasivesurgerycomparedtoconventionalopenprocedures.Incontrast,littleisknownabouttheeffectofminimalinvasive approachontherecoveryofbowelmotilityafterurologicsurgery.Weperformedanoverviewofthepotentialbenefitofminimal invasiveapproachonPOIforurologicprocedures.ThemechanismsandriskfactorsresponsiblefortheonsetofPOIarediscussed with emphasis on the advantages of minimal invasive approach. In the urologic field, POI is the main complication following radicalcystectomybutitisrarelyofclinicalsignificanceforotherminimalinvasiveinterventions.Laparoscopyorroboticassisted laparoscopictechniqueswhenstudiedindividuallymayreducetotheirownthedurationandpreventtheonsetofPOIinasubset ofprocedures.Thepotentialinfluenceofageandurinarydiversiontypeonpostoperativeileusiscontradictoryintheliterature. ThereissomeevidencesuggestingthatBMI,bloodloss,urinaryextravasation,existenceofamajorcomplication,bowelresection, operativetimeandtransperitonealapproachareindependentriskfactorsforPOI.TreatmentofPOIremainselusive.Oneofthe mostimportantandeffectivemanagementstrategiesforpatientsundergoingradicalcystectomyhasbeenthedevelopmentanduse ofenhancedrecoveryprograms.AnoptimalrationalstrategytoshortenthedurationofPOIshouldincorporateminimalinvasive approachwhenappropriateintomultimodalfasttrackprogramsdesignedtoreducePOIandshortenLOS.

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