Risk factors for postoperative ileus after colorectal cancer surgery

Rybakov, E. G.; Shelygin, Yu. A.; Khomyakov, E. A.; Зароднюк, И. В.

doi:10.1111/codi.13888

Cited by 30 publications

(35 citation statements)

References 13 publications

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“…Despite remarkable progress in the field of colorectal surgery, postoperative complications remain a major problem during the course of colorectal cancer treatment . After colorectal surgery, postoperative ileus (POI) occurs at a frequency of 10%‐17%, resulting in longer hospital stays and higher costs . POI is characterized by lack of bowel sounds, delayed passage of flatus and stool, abdominal distension, nausea, vomiting, and pain .…”

Section: Introductionmentioning

confidence: 99%

“…Compared to open surgery, laparoscopic colorectal surgery is associated with lower incidence of postoperative bowel obstruction . Some studies have reported that body mass index (BMI), which is widely used for the assessment of general obesity, is also a risk factor for POI . However, recent findings suggest that, compared to BMI, visceral obesity (VO) is more strongly associated with complications after colorectal surgery .…”

Section: Introductionmentioning

confidence: 99%

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Visceral obesity is a preoperative risk factor for postoperative ileus after surgery for colorectal cancer: Single‐institution retrospective analysis

Morimoto

Takahashi

Fujii

et al. 2019

Annals of Gastroent Surgery

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Aim: Visceral obesity (VO) reportedly has a stronger association with complications after colorectal surgery than does body mass index. Here, we retrospectively assessed VO as a risk factor for postoperative ileus (POI) after colorectal resection in patients with colorectal cancer.Methods: This study included 417 consecutive patients with colorectal cancer who underwent elective surgery at our institute from January 2010 to December 2012.Visceral fat area (VFA) was calculated by image analysis software. VO was defined as VFA ≥100 cm 2 . We assessed 49 factors, including VO, comorbidities, surgical procedure, and postoperative complications. Data were analyzed using a propensity scorematching strategy.Results: Postoperative ileus occurred in 18 patients (4.3%) from the entire cohort, and in 14 (5.5%) of the 256 matched patients. Multivariate analysis (n = 417 patients) showed that significant risk factors for POI included VO (OR 7.9, 95% confidence interval [CI] 1.9-32.1, P = .004), open surgery (OR 6.4, 95% CI 1.6-26.7, P = .010), and pelvic/intra-abdominal abscess (OR 11.0, 95% CI 1.1-110.2, P = .041). Propensity score matching showed two independent risk factors in the multivariate analysis: VO (OR 6.2, 95% CI 1.3-30.4, P = .025) and open surgery (OR 9.1, 95% CI 2.0-40.5, P = .004). Conclusion:Visceral obesity may be an independent risk factor for POI in patients with colorectal cancer. K E Y W O R D Scolorectal cancer, ileus, obesity, postoperative complication, surgery

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Visceral obesity is a preoperative risk factor for postoperative ileus after surgery for colorectal cancer: Single‐institution retrospective analysis

Morimoto

Takahashi

Fujii

et al. 2019

Annals of Gastroent Surgery

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“…We read the study by Rybakov and colleagues in which the authors assess the rate and independent risk factors for postoperative ileus (POI) after colorectal cancer surgery. The results provide evidence of at least two surgeon‐dependent risk factors, i.e.…”

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confidence: 99%

Risk factors for postoperative ileus after colorectal cancer surgery: methodological issues

Weng

Wang

2018

Colorectal Disease

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“…The use of small effective sample sizes reduces the model's power and precision around significant variables. In addition, important variables associated with POI in previous studies, such as preoperative chronic narcotic use and intraoperative adhesions, were missing from the development cohort. However, although not a perfect surrogate, duration of surgery may reflect intraoperative adhesions and operative difficulty.…”

Section: Discussionmentioning

confidence: 99%

Prediction model and web-based risk calculator for postoperative ileus after loop ileostomy closure

Garfinkle

Filion

Bhatnagar³

et al. 2019

British Journal of Surgery

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Background: Postoperative ileus (POI) is a significant complication after loop ileostomy closure given both its frequency and impact on the patient. The purpose of this study was to develop and externally validate a prediction model for POI after loop ileostomy closure. Methods: The model was developed and validated according to the TRIPOD checklist for prediction model development and validation. The development cohort included consecutive patients who underwent loop ileostomy closure in two teaching hospitals in Montreal, Canada. Candidate variables considered for inclusion in the model were chosen a priori based on subject knowledge. The final prediction model, which modelled the 30-day cumulative incidence of POI using logistic regression, was selected using the highest area under the receiver operating characteristic curve (AUC) criterion. Model calibration was assessed using the Hosmer-Lemeshow goodness-of-fit test. The model was then validated externally in an independent cohort of similar patients from the University of British Columbia. Results: The development cohort included 531 patients, in whom the incidence of POI was 16⋅8 per cent. The final model included five variables: age, ASA fitness grade, underlying pathology/treatment, interval between ileostomy creation and closure, and duration of surgery for ileostomy closure (AUC 0⋅68, 95 per cent c.i. 0⋅61 to 0⋅74). The model demonstrated good calibration (P = 0⋅142). The validation cohort consisted of 216 patients, and the incidence of POI was 15⋅7 per cent. On external validation, the model maintained good discrimination (AUC 0⋅72, 0⋅63 to 0⋅81) and calibration (P = 0⋅538). Conclusion: A prediction model was developed for POI after loop ileostomy closure and included five variables. The model maintained good performance on external validation.

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Risk factors for postoperative ileus after colorectal cancer surgery

Abstract: 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.

Cited by 30 publications

References 13 publications

Visceral obesity is a preoperative risk factor for postoperative ileus after surgery for colorectal cancer: Single‐institution retrospective analysis

Visceral obesity is a preoperative risk factor for postoperative ileus after surgery for colorectal cancer: Single‐institution retrospective analysis

Risk factors for postoperative ileus after colorectal cancer surgery: methodological issues

Prediction model and web-based risk calculator for postoperative ileus after loop ileostomy closure

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