Risk factors for prolonged ileus after resection of colorectal cancer

An observational study of 2400 consecutive patients

Pierre H. Chapuis, Les Bokey, Anil Keshava, Matthew J F X Rickard, Peter Stewart, Christopher J. Young, Owen F. Dent*

*Corresponding author for this work

    Research output: Contribution to journalArticle

    84 Citations (Scopus)

    Abstract

    OBJECTIVE: Prolonged ileus - the failure of postoperative ileus to resolve within a few days after major abdominal surgery - leads to significant medical consequences for the patient and costs to the hospital system. The aim of this retrospective analysis of prospectively collected data was to identify independent preoperative and intraoperative risk factors for prolonged ileus in a large consecutive series of patients who had undergone resection for colorectal cancer. METHODS: Patients were drawn from a hospital registry of 2400 consecutive resections over the period 1995-2009. Thirty-four potential predictors of prolonged ileus were analyzed by logistic regression. RESULTS: Prolonged ileus occurred in 14.0% of patients. Statistically significant independent predictors of prolonged ileus were male sex (OR: 1.7, P < 0.001), peripheral vascular disease (OR: 1.8, P < 0.001), respiratory comorbidity (OR: 1.6, P < 0.001), resection at urgent operation (OR: 2.2, P < 0.001), perioperative transfusion (OR: 1.6, P < 0.010), stoma constructed (OR: 1.4, P < 0.001), and operation lasting ≥3 hours (OR: 1.6, P < 0.001). CONCLUSIONS: These features can be used to alert medical and nursing staff to patients likely to experience prolonged ileus after bowel resection so that they can be monitored closely in the postoperative period and available treatments targeted toward them. These features may also be useful in the research context to facilitate the more efficient selection of high-risk patients as subjects in clinical trials of prevention or treatment.

    Original languageEnglish
    Pages (from-to)909-915
    Number of pages7
    JournalAnnals of Surgery
    Volume257
    Issue number5
    DOIs
    Publication statusPublished - May 2013

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