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- Title
Risk factors for prolonged ileus following colon surgery.
- Authors
Moghadamyeghaneh, Zhobin; Hwang, Grace; Hanna, Mark; Phelan, Michael; Carmichael, Joseph; Mills, Steven; Pigazzi, Alessio; Stamos, Michael; Hwang, Grace S; Hanna, Mark H; Carmichael, Joseph C; Stamos, Michael J
- Abstract
<bold>Background: </bold>Prolonged ileus is one of the most common postoperative complications after colorectal surgery. We sought to investigate the predictors of prolonged ileus following elective colon resections procedures.<bold>Methods: </bold>The national participant user files of NSQIP databases were utilized to examine the clinical outcomes of patients undergoing elective colon resection during 2012-2013. Multivariate regression analysis was performed to investigate predictors of prolonged ileus. Prolonged ileus was defined as no return of bowel function in 7 days.<bold>Results: </bold>We sampled a total of 27,560 patients who underwent colon resections; of these, 3497 (12.7%) patients had prolonged ileus. Patients with ileocolonic anastomosis (ICA) had a significantly higher rate of prolonged ileus compared to patients with colorectal anastomosis (CRA) (15 vs. 11.5%, AOR 1.25, P < 0.01). Prolonged ileus was significantly associated with intra-abdominal infections (13 vs. 2.8%, AOR 2.56, P < 0.01) and anastomotic leakage (12 vs. 2.4%, AOR 2.50, P < 0.01). Factors such as preoperative sepsis (AOR 1.63, P < 0.01), disseminated cancer (AOR 1.24, P = 0.01), and chronic obstructive pulmonary disease (AOR 1.27, P = 0.02) were associated with an increased risk of prolonged ileus, whereas oral antibiotic bowel preparation (AOR 0.77, P < 0.01) and laparoscopic surgery (AOR 0.51, P < 0.01) are associated with decreased prolonged ileus risk.<bold>Conclusions: </bold>Prolonged ileus is a common condition following colon resection, with an incidence of 12.7%. Among colon surgeries, colectomy with ICA resulted in the highest rate of postoperative prolonged ileus. Prolonged ileus is positively associated with anastomotic leak and intra-abdominal infections; thus, a high index of suspicion must be had in all patients with prolonged postoperative ileus.
- Subjects
COLON surgery; BOWEL obstructions; SURGICAL complications; SURGICAL anastomosis; GASTROINTESTINAL system obstructions
- Publication
Surgical Endoscopy & Other Interventional Techniques, 2016, Vol 30, Issue 2, p603
- ISSN
1866-6817
- Publication type
journal article
- DOI
10.1007/s00464-015-4247-1