Laparoscopic colectomy shortens postoperative ileus in a canine model

Background. Proponents of laparoscopic colectomy claim a more rapid return of gastrointestinal function, but objective data supporting this contention are lacking. Our aim was to compare the duration of delay in gastrointestinal transit after total laparoscopic, laparoscopic-assisted, and open colonic resection. Methods. Thirty-nine female dogs were assigned to three groups: group 1, laparoscopic colectomy; group 2, laparoscopic-assisted colectomy; and group 3, open colectomy. Transit studies were performed before operation and on days 1, 2, 3, and 5 after a mid-descending colectomy with end-to-end anastomosis. Gastric emptying of liquids and small bowel transit of liquids were determined by means of radionuclide techniques. Gastric emptying of solids and colonic transit were measured by following transit of radiopaque spheres instilled into the stomach and proximal colon, respectively. Results. With each dog as its own control, gastric emptying returned to preoperative values by 2 days in group 1, 3 days in group 2, and 5 days in group 3. Small bowel transit returned to preoperative values on day 3 for groups 1 and 2 and on day 5 for group 3. Gastric emptying of solids and colonic transit returned to preoperative values on day 3 for group 1 and on day 5 for groups 2 and 3. Conclusions. These observations show that laparoseopic resection techniques in this canine model resulted in a more rapid return to normal gastrointestinal transit compared with open colectomy.