Risk factors for postoperative ileus after colorectal cancer surgery.

Autor: Rybakov EG; State Scientific Centre of coloproctology, Moscow, Russia., Shelygin YA; State Scientific Centre of coloproctology, Moscow, Russia.; Russian Medical Academy of Continuous Professional Education., Khomyakov EA; State Scientific Centre of coloproctology, Moscow, Russia., Zarodniuk IV; State Scientific Centre of coloproctology, Moscow, Russia.
Jazyk: angličtina
Zdroj: Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland [Colorectal Dis] 2017 Sep 16. Date of Electronic Publication: 2017 Sep 16.
DOI: 10.1111/codi.13888
Abstrakt: Aim: To assess the rate and independent risk factors of postoperative ileus (POI) after colorectal cancer surgery.
Methods: Three hundred consecutive patients underwent colorectal surgery for cancer at the State Scientific Centre of coloproctology, Moscow, Russia, between November 2015 and August 2016. POI was diagnosed as an absence of intestinal function for 72 hours or more after operation and confirmed by plain radiography. Uni- and multivariate logistic regression of the tumour-, patient- and treatment-related factors was performed. All patients had epidural catheters with multimodal analgesia.
Results: Thirty-nine patients (13%) had postoperative ileus. The variables associated with this condition in univariate analysis were age < 64 y.o. (p = 0.02), male gender (p = 0.02), BMI ≥ 25 kg/m 2 (p = 0.02), moderate drinking (p = 0.02), heavier drinking (p < 0.0001), opioids (p = 0.02), history of abdominal operation (p = 0.003), firm, extensive adhesions as a result of previous surgery (p = 0.005), multivisceral resection (p = 0.009), blood loss ≥ 150 mL (p = 0.006), haemotransfusion (p = 0.01) and open approach (p = 0.006). In the multivariate logistic regression, BMI ≥ 26 kg/m 2 (p = 0.008), opioids (p = 0.04) history of abdominal operation (p = 0.04) and adhesions (p = 0.03) were identified as independent risk factors.
Conclusion: Postoperative ileus is a common complication in colorectal surgery. The results of our study suggest at least two surgeon-dependent risk factors, i.e., open approach and opioids in the postoperative period. This article is protected by copyright. All rights reserved.
(This article is protected by copyright. All rights reserved.)
Databáze: MEDLINE
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