The IMAGINE (Ileus MAnaGement INtErnational) study was led by EUROSurg and supported directly by STARSurg in the UK. The study looked to explore one of the most common post-operative complications following elective colorectal surgery: Ileus. At the time, guidance on the management of postoperative ileus was conflicting, although it was known to be associated with an increased incidence of postoperative adverse events.

We developed and ran a multi-centre cohort study lead by students and trainees across the UK and Australasia and included all adult patients undergoing elective colorectal surgery between January and April 2018. The primary aim of the study was to evaluate the time to gastrointestinal (GI) recovery using a combination of return to normal bowel function and oral tolerance. Secondary aims looked to explore the impact of NSAIDs on recovery of GI function alongside safety data with respect to anastomotic leak, acute kidney injury and other complications within 30 days of surgery.

The study ran with great success involving 4164 patients in the final dataset. The key findings from this study were:

• The use of postoperative NSAIDs did not reduce the time to GI recovery.
• The use of postoperative NSAIDs, when used between post-operative days 1-3 appeared safe.