American Journal of Obstetrics & Gynecology
Volume 196, Issue 4 , Pages 311.e1-311.e7 , April 2007

Effect of laxatives on gastrointestinal functional recovery in fast-track hysterectomy: a double-blind, placebo-controlled randomized study

  • Charlotte T. Hansen, MD

      Affiliations

    • Department of Gynecology and Obstetrics, Hvidovre University Hospital, Copenhagen, Denmark
  • ,
  • Mette Sørensen, RN

      Affiliations

    • Department of Gynecology and Obstetrics, Hvidovre University Hospital, Copenhagen, Denmark
  • ,
  • Charlotte Møller, MD, PhD

      Affiliations

    • Department of Gynecology and Obstetrics, Viborg Hospital, Viborg, Denmark
  • ,
  • Bent Ottesen, MD, DMSc

      Affiliations

    • Department of Gynecology and Obstetrics, the Juliane Marie Center, Rigshospitalet, Copenhagen, Denmark
  • ,
  • Henrik Kehlet, MD, DMSc

      Affiliations

    • Section for Surgical Pathophysiology, the Juliane Marie Center, Rigshospitalet, Copenhagen, Denmark.

Received 24 May 2006 ,Accepted 25 October 2006.

References 

  1. Kehlet H, Dahl JB. Anaesthesia, surgery and challenges in postoperative recovery. Lancet. 2003;362:1921–1928
  2. Møller C, Kehlet H, Friland SG, Schouenborg LO, Lund C, Ottesen B. Fast-track hysterectomy. Eur J Obstet Gynecol Reprod Biol. 2001;98:18–22
  3. Basse L, Thorbøl JE, Løssl K, Kehlet H. Colonic surgery with accelerated rehabilitation or conventional care. Dis Colon Rectum. 2004;47:271–278
  4. Basse L, Madsen L, Kehlet H. Normal gastrointestinal transit after colonic resection using epidural analgesia, enforced oral nutrition and laxative. Br J Surg. 2001;88:1498–1500
  5. Kraus K, Fanning J. Prospective trial of early feeding and bowel stimulation after radical hysterectomy. Am J Obstet Gynecol. 2000;182:996–998
  6. Fanning J, Yu-Brekke S. Prospective trial of aggressive postoperative bowel stimulation following radical hysterectomy. Gynecol Oncol. 1999;73:412–414
  7. Altman DG, Schultz KF, Moher D, et al. The revised CONSORT statement for reporting randomized trials: explanation and elaboration. Ann Intern Med. 2001;134:663–694
  8. Altman DG. Practical statistics for medical research. London: Chapman & Hall; 1991;
  9. Holte K, Kehlet H. Postoperative ileus: progress towards effective management. Drugs. 2002;62:2603–2615
  10. Kehlet H. Preventive measures to minimize or avoid postoperative ileus. Semin Colon Rectal Surg. 2005;16:203–207
  11. Werner MU, Gaarn-Larsen L, Basse L, et al. Postoperative pain and gastrointestinal recovery after colonic resection with epidural analgesia and multi-modal rehabilitation. Acute Pain. 2005;7:5–11
  12. Marx C, Rasmussen T, Jakobsen DH, et al. The effect of accelerated rehabilitation on recovery after surgery for ovarian malignancy. Acta Obstetricia et Gynecologica. 2006;85:488–492
  13. DeLoach LJ, Higgins MS, Caplan AB, Stiff JL. The visual analog scale in the immediate postoperative period: intrasubject variability and correlation with a numeric scale. Anesth Analg. 1998;86:102–106
  14. Jørgensen H, Fomsgaard JS, Dirks J, Wetterslev J, Dahl JB. Effect of continuous epidural 0.2% riouvacaube vs 0.2% bupivacaine on postoperative pain, motor block and gastrointestinal function after abdominal hysterectomy. Br J Anaesth. 2000;84:144–150
  15. Holzer A, Jirecek ST, Illievich UM, Huber J, Wenzl RJ. Laparoscopic versus open myomectomy: a double-blind study to evaluate postoperative pain. Anesth Analg. 2006;102:1480–1484
  16. Jørgensen H, Fomsgaard JS, Dirks J, Wetterslev J, Andreasson B, Dahl JB. Effect of peri- and postoperative epidural anaesthesia on pain and gastrointestinal function after abdominal hysterectomy. Br J Anaesth. 2001;87:577–583
  17. Gimbel H, Zobbe V, Andersen BM, Filtenborg T, Gluud C, Tabor A. Randomised controlled trial of total compared with subtotal hysterectomy with one-year follow up results. BJOG. 2003;110:1088–1098
  18. Møller C, Kehlet H, Utzon J, Ottesen B. Hysterectomy in Denmark: an analysis of postoperative hospitalisation, morbidity and readmission. Dan Med Bull. 2002;49:353–357
  19. Harkki-Siren P, Sjoberg J, Toivonen J, Tiitinen A. Clinical outcome and tissue trauma after laparoscopic and abdominal hysterectomy: a randomized controlled study. Acta Obstet Gynecol Scand. 2000;79:866–871
  20. Farquhar CM, Sadler L, Harvey S, McDougall J, Yazdi G, Meuli K. A prospective study of the short-term outcomes of hysterectomy with and without oophorectomy. Aust N Z J Obstet Gynaecol. 2002;42:197–204
  21. Garry R, Fountain J, Mason S, et al. The EVALUATE study: two parallel randomised trials, one comparing laparoscopic with abdominal hysterectomy, the other comparing laparoscopic with vaginal hysterectomy. BMJ. 2004;328:129

 Cite this article as: Hansen CT, Sørensen M, Møller C, Ottesen B, Kehlet H. Effect of laxatives on gastrointestinal functional recovery in fast-track hysterectomy: a double-blind, placebo-controlled randomized study. Am J Obstet Gynecol 2007;196:311.e1-311.e7.

 Reprints not available from the authors

 Supported by the Juliane Marie Center, Rigshospitalet, Department of Gynaecology and Obstetrics, Hvidovre University Hospital, and Ferring Pharmaceuticals, Copenhagen, Denmark.

PII: S0002-9378(06)02217-4

doi: 10.1016/j.ajog.2006.10.902

American Journal of Obstetrics & Gynecology
Volume 196, Issue 4 , Pages 311.e1-311.e7 , April 2007