Risk Factors for Prolonged Ileus After Resection of Colorectal Cancer

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

doi:10.1097/sla.0b013e318268a693

Cited by 188 publications

(167 citation statements)

References 12 publications

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“…''High'' (Q4) DOS fluid patients had increased likelihood of longer LOS, increased POI, and increased cost compared to patients with DOS fluids in the second and third quartiles. Although the overall LOS and POI incidence are consistent with those reported in the literature, 11 we have shown an association with the amount of fluid given on the DOS. In all instances, adjusted and unadjusted, worse outcomes are seen in the extremes of fluid administration.…”

Section: Discussionsupporting

confidence: 90%

Perioperative Fluid Utilization Variability and Association With Outcomes

et al. 2016

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Section: Discussionsupporting

confidence: 90%

Perioperative Fluid Utilization Variability and Association With Outcomes

et al. 2016

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“…Data from large-scale retrospective studies revealed many risk factors of POI including male sex, high ASA score, respiratory disease, and stoma construction [38,39]. Unfortunately, it remains unclear from the literature whether those identified risk factors entail a satisfactory predictive value that allows a prospective application for predicting POI, and more importantly, whether patients with these risk factors require different interventions for the purpose of preventing POI.…”

Section: Discussionmentioning

confidence: 99%

“…However, the applicability of a retrospective analysis might greatly vary in different centers, depending on patients' characteristics. For instance, none of the three independent risk factors in this scoring system reached significance in the analyses from other databases [38,39,40]. Different centers, therefore, need to consider or even reevaluate the applicability of the predictive scoring systems from other databases.…”

Section: Discussionmentioning

confidence: 99%

Clinical Endpoint, Early Detection, and Differential Diagnosis of Postoperative Ileus: A Systematic Review of the Literature

Wu¹,

Boersema²,

Dereci³

et al. 2014

Eur Surg Res

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Background: This systematic review summarizes evidence regarding clinical endpoints, early detection, and differential diagnosis of postoperative ileus (POI). Methods: Using MEDLINE, EMBASE, Cochrane, and Web-of-Science, we identified 2,084 articles. Risk of bias and level of evidence (LOE) of the included articles were determined, and relevant results were summarized. Results: Eleven articles were included, most of which with substantial risks of bias. Bowel motility studies revealed that defecation together with solid food tolerance is the most representative clinical endpoint of POI (LOE: 2b); other clinical signs (e.g. bowel sounds, passage of flatus) did not correlate with a full recovery of bowel motility. Inflammatory parameters including interleukin (IL)-6, IL-1, and TNF-α might assist in an early detection of prolonged POI (LOE: 4). Clinical manifestations (e.g. nausea, vomiting, abdominal distension, bowel sounds, flatus) and X-ray examinations provided limited aid to the differential diagnosis of POI, while CT with Gastrografin had the best specificity and sensitivity (both 100%; LOE: 1c). Conclusions: Postoperative defecation together with tolerance of solid food intake seems to be the best clinical endpoint of POI. CT has the best differential diagnostic value between POI and other complications. Prospective studies with a high LOE are in great need. © 2014 S. Karger AG, Basel

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“…Therefore, comorbidities should be identified and adjusted for as confounding factors in clinical outcome studies. A mounting body of evidence has demonstrated independent effects of comorbid conditions including preoperative sepsis, disseminated cancer, peripheral vascular disease, and chronic obstructive pulmonary disease on the incidence of POI [19–21]. However, no studies have used a validated comorbidity score to account for the overall effect of medical comorbid conditions on the risk of prolonged POI after surgical resection of CRC.…”

Section: Introductionmentioning

confidence: 99%

Age-adjusted charlson comorbidity index score as predictor of prolonged postoperative ileus in patients with colorectal cancer who underwent surgical resection

Tian

et al. 2017

Oncotarget

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Comorbidities had considerable effects on the development of postoperative ileus (POI). The primary aim of the present study was to determine the influence of the age-adjusted Charlson comorbidity index (ACCI) score on the risk of prolonged POI in patients with colorectal cancer who underwent surgical resection. Using the electronic Hospitalization Summary Reports, we identified 11,397 patients with colorectal cancer who underwent surgical resection from 2013 through 2015. Logistic regression models were applied to evaluate the effect of the ACCI score on the risk of prolonged POI. The ACCI score had a positive graded association with the risk of prolonged POI in both colon and rectal cancer (P for trend < 0.05). Among patients with rectal cancer, after adjusting for potential confounders, those with an ACCI score of 4–5 had a 108% higher risk of prolonged POI than those with an ACCI score of 0–1 (odds ratio [OR], 2.08; 95% confidence interval [CI], 1.09–3.98), and those with an ACCI score of ≥ 6 had a 130% higher risk (OR, 2.30; 95% CI, 1.08–4.89). Among patients with colon cancer, those with an ACCI score of ≥ 6 had a 47% greater risk of prolonged POI than those with an ACCI score of 0–1 (OR, 1.47; 95% CI, 1.07–2.02). These findings suggested that a higher ACCI score was an independent predictor of the development of prolonged POI.

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Risk Factors for Prolonged Ileus After Resection of Colorectal Cancer

Cited by 188 publications

References 12 publications

Perioperative Fluid Utilization Variability and Association With Outcomes

Perioperative Fluid Utilization Variability and Association With Outcomes

Clinical Endpoint, Early Detection, and Differential Diagnosis of Postoperative Ileus: A Systematic Review of the Literature

Age-adjusted charlson comorbidity index score as predictor of prolonged postoperative ileus in patients with colorectal cancer who underwent surgical resection

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