The effect of neostigmine on postoperative ileus and the healing of colon anastomoses.

OBJECTIVES: The aim of this study was to assess the effects of neostigmine on the postoperative ileus and the healing of colon anastomoses.

BACKGROUND: Anastomotic leaks and postoperative ileus are among the most important complications in colorectal surgery. Nutritional status of the patient is one of the most important factors of the anastomoses healing.

METHODS: Forty Wistar-albino rats were randomly assigned to (1) colon anastomoses + protein-enriched diet + 1 microg neostigmine, (2) colon anastomoses + protein-enriched diet, (3) colon anastomoses + 30 % dextrose + 1 microg neostigmine, (4) colon anastomoses + 30% dextrose. Body weights, quantities of the consumed products and feces weight change were measured at the first and second 48 hours postoperatively. All rats were sacrificed on the 5th postoperative day. Then, the healing of anastomosis was evaluated by measuring of body weights, burst pressure and hydroxyproline level.

RESULTS: There were significant differences between the groups 1 and 2 (p < 0.001), and the groups 3 and 4 regarding the preoperative and postoperative mean weight (p < 0.001). The group 2 did not show any weight loss, whereas the group 1 demonstrated a significant weight gain (p < 0.001). The group 4 showed a significant weight reduction compared to the preoperative period, while the group 3 exhibited a significantly lower weight loss compared to the group 4 (p < 0.001). There were significant differences regarding the burst pressure and hydroxyproline level values of groups with and without neostigmine administration (p < 0.001).

CONCLUSION: Starting the early intake of nutrition with neostigmine in the postoperative period reduced the postoperative ileus and increased the healing of colon anastomoses (Tab. 4, Fig. 5, Ref. 27).