Impact of post-operative paralytic ileus on post-operative outcomes after surgery for colorectal cancer: a single-institution, retrospective study

Autor: Ryota Matsui, Kunihiko Nagakari, Moeko Igarashi, Ryosuke Hatta, Tomohiro Otsuka, Jun Nomoto, Shintaro Kohama, Daisuke Azuma, Kazuhiro Takehara, Tomoya Mizuno, Masakazu Ohuchi, Shinichi Oka, Jiro Yoshimoto, Noriyuki Inaki, Masaki Fukunaga, Yoichi Ishizaki
Rok vydání: 2022
Předmět:
Zdroj: Surgery Today. 52:1731-1740
ISSN: 1436-2813
0941-1291
Popis: Post-operative paralytic ileus (POI) occurs after surgery because of gastrointestinal dysfunction caused by surgical invasion. We therefore investigated the frequency of POI after laparoscopic colorectal surgery in patients with colorectal cancer using a strictly defined POI diagnosis and identified associated risk factors.Patients who underwent initial laparoscopic surgery for colorectal cancer between January 2014 and December 2018 were included. The primary end point was the incidence of POI. A multivariate logistic regression analysis revealed the contributing risk factors for POI.Of the 436 patients, 94 (21.6%) had POI. Compared with the non-POI group, the POI group had significantly higher frequencies of infectious complications (p 0.001), pneumonia (p 0.001), intra-abdominal abscess (p = 0.012), anastomotic leakage (p = 0.016), and post-operative bleeding (p = 0.001). In the multivariate analysis, the right colon (odds ratio [OR] 2.180, p = 0.005), pre-operative chemotherapy (OR 2.530, p = 0.047), pre-operative antithrombotic drug (OR 2.210, p = 0.032), and post-operative complications of CD grade ≥ 3 (OR 12.90, p 0.001) were independent risk factors for POI.Post-operative management considering the risk of post-operative bowel palsy may be necessary for patients with right colon, pre-operative chemotherapy, pre-operative antithrombotic drug or severe post-operative complications.
Databáze: OpenAIRE
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