Gastrointestinal Electrical Stimulation as Prevention of Postoperative Ileus-A Blinded Randomized Controlled Porcine Trial.

Abstract

Introduction: Postoperative ileus (POI) is a condition characterized by a transient cessation of gastrointestinal function caused by surgical trauma and represents a clinical challenge after major abdominal surgery. Despite abdominal surgery being performed frequently and that a diverse range of treatment options for POI has been investigated, no single intervention has proven effective.

Aim: This randomized controlled animal study aimed to investigate the effect of postoperative electrical sigmoid colonic stimulation as a treatment of POI and to explore gastrointestinal motility in POI using a wireless motility capsule.

Method: Sixteen pigs were used as study material. All animals underwent a previously developed surgical POI model procedure. A wireless motility capsule (SmartPill, Given Imaging) was inserted in the jejunum or colon. Two pace wires were attached to the sigmoid colon and connected to a pacemaker (Enterra; Medtronic). Animals were randomized to having the pacemaker turned on (experimental group) or turned off (control group). Postoperative gastrointestinal function was observed daily. Intestinal motility was monitored using the SmartPill system. Animals were terminated after regaining normal gastrointestinal function.

Results: All animals in the intervention group passed stool on the first postoperative day, whereas the control group passed stool between the second and the fourth postoperative day (p = 0.001). The number of days till food intake was 1 (range 1-2) in the intervention group and 2 (range 1-3) in the control group (p = 0.02).

Conclusion: This study demonstrated improved gastrointestinal recovery time from electrical stimulation as measured by time to first stool and time to first food intake. These novel findings warrant further clinical studies within this field.