Background: Postoperative ileus is a complication that may result in the longer duration of stay and decreases the quality of life of patients. Previous studies have found some factors related to postoperative ileus. This study aimed to determine the risk factor of postoperative ileus in laparotomic resection and anastomosis surgery. Methods: Patients who underwent laparotomic resection and anastomosis surgery during January 2019 – July 2020 were included. Postoperative ileus was diagnosed in fourth day after surgery. The variables included in this study are age, gender, BMI, pathology site, duration of surgery, type of anastomosis, length of resection. Result: Fifty laparotomic resection and anastomosis surgery patients were included in this study, 50% of subjects is patients with postoperative ileus. Patient aged 65 years old or older had a higher incidence postoperative ileus (68% vs 28%; RR 2.3 95% CI: 1.23-4.33; p value: 0.010). Study also found duration of surgery 180 minutes or longer also had higher incidence postoperative ileus (79% vs 36%; RR: 2.49 95% CI: 1.20-5.15; p value: 0.010). Conclusion: This study concludes that age 65 years old or older and duration of surgery 180 minutes or longer are significant risk factor to postoperative ileus in laparotomic resection and anastomosis surgery patients.
Background: Postoperative paralytic ileus is a physiological response of the intestine to surgical stress. However, if this condition lasts more than 3 days, it is pathological. Some factors related to postoperative ileus have been identified, but the results are still confusing. This study aimed to identify risk factors of postoperative ileus following laparotomy for anastomosis and resection of the gastrointestinal tract at Prof. Dr. I.G.N.G. Ngoerah Hospital. Method: This was a retrospective cohort study between January 2019 until July 2020. The subjects were recruited consecutively, which included adult patients who had undergone laparotomic surgery with anastomosis and resection. Data was taken in Prof. Dr. I.G.N.G. Ngoerah Hospital until the needed samples were fulfilled. Data were analyzed using SPSS version 24 for Windows. Result: There were 50 subjects aged from 32 to 74 years old in this study. About 62% of subjects were female. Analysis showed a correlation between postoperative ileus occurrence and Age; it also correlates with the operation duration. Multivariate analysis found that patients aged 65 years and older have a 5.96 greater risk of developing postoperative ileus than younger patients (95% CI 1.55-22.99; p=0.010). This study also found that an operation lasting 180 minutes or more had a 6.14 greater risk of postoperative ileus than a shorter surgery duration (95% CI 1.57-24.05; p=0.009). Conclusion: Age over 65 years old and duration of operation more than 3 hours were associated with postoperative paralytic ileus in adult patients who had undergone laparotomy for anastomosis and resection of the gastrointestinal tract. Latar Belakang: Ileus paralitik pasca operasi merupakan sebuah respon fisiologis usus terhadap stress pembedahan. Namun ketika ileus yang terjadi berlangsung lebih dari 3 hari maka kondisi ini masuk dalam kondisi patologis. Beberapa faktor sudah diidentifikasi untuk memprediksi kejadian ileus post operasi namun hasilnya masih ambigu. Penelitian ini bertujuan mengetahui faktor risiko ileus paralitik patologis pasca operasi pada populasi pasien laparatomi reseksi dengan anastomosis di RSUP Prof. Dr. I.G.N.G. Ngoerah. Metode: Penelitian ini menggunakan pendekatan kohort retrospektif yang berlangsung sejak Januari 2019 hingga Juli 2020. Pengambilan data dilakukan dengan metode konsekutif sampling pada pasien dewasa. Pengambilan data dilakukan di RSUP Prof. Dr. I.G.N.G. Ngoerah sampai jumlah sampel terpenuhi. Data dianalisis dengan SPSS versi 24 untuk Windows. Hasil: Sebanyak 50 subjek diikutsertakan dalam penelitian ini dengan rentang usia 32 hingga 74 tahun. Sebanyak 62% adalah perempuan. Pada analisis ditemukan adanya hubungan usia dan durasi operasi dengan kejadian ileus post operasi. Pada analisis multivariat ditemukan bahwa usia di atas 65 tahun memiliki risiko mengalami ileus post operasi 5,96 kali lebih besar dibanding usia yang lebih muda (95% IK=1,55-22,99; p=0,010). Selain itu juga ditemukan operasi yang berlangsung selama 180 menit atau lebih memiliki risiko 6.14 kali lebih besar mengalami ileus post operasi dibanding durasi operasi yang lebih singkat (95% IK=1,57–24,05; p=0,009). Simpulan: Usia pasien di atas 65 tahun dan durasi operasi lebih dari 3 jam berhubungan dengan kejadian ileus paralitik patologis paska operasi pada pasien yang menjalani operasi laparotomi dengan reseksi dan anastomosis.
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