Smoking Status is Associated with Postoperative Ileus after Colon Resection for Diverticular Disease

Khoury, Mitri K.; Grubbs, Jordan; Abdelsayed, John; Abdelnaby, Abier

doi:10.1016/j.jamcollsurg.2019.08.989

Cited by 2 publications

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“…Previous studies found many preoperative variables to be associated with the development of POI after abdominal surgery ( 4 , 10 , 11 , 13 , 15 – 18 , 35 – 37 ), as can be seen in Table 2 .…”

Section: Discussionmentioning

confidence: 93%

Men and Those With a History of Smoking Are Associated With the Development of Postoperative Ileus Following Elective Colorectal Cancer Resection at a Private Academic Hospital in Johannesburg, South Africa: A Retrospective Cohort Study

et al. 2021

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Introduction: A scarcity of local published data on colorectal cancer (CRC) postoperative complications, including postoperative ileus (POI), exists. POI is a temporary gastrointestinal (GI) state of absent or reduced gastric motility shown to increase patient morbidity, prolong length-of-stay (LOS), and intensify the healthcare resource burden. The pathogenesis of POI involves a neurogenic and inflammatory phase plus a pharmacological component.Aim and Objectives: This study aimed to determine centre-specific preoperative risk factors associated with the development of ileus post elective therapeutic CRC resection. The objectives were to determine whether patient demographics; functional status; comorbidities; GI history; pharmacotherapy (including neoadjuvant chemotherapy); and lastly neoadjuvant radiation and chemoradiation were associated with the development of POI.Method: Patients who underwent CRC resection between January 2016 and May 2019 were retrospectively identified from an existing database. Urgent—or non-therapeutic surgeries; surgeries with the complication anastomotic leak or GI obstruction; patients under 18 at the time of surgery or surgeries preceded by preoperative parenteral nutrition were excluded. A comparison was done of the incidence of exposure in the study cohort to investigated variables as potential risk factors for the complication POI.Results: A total of 155 patient cases were included, and 56 (36%) of them developed POI. Univariate comparison of patients who developed POI with demographic characteristics of patients who did not suggested that women were at lower risk to develop POI compared to men (p = 0,013; RR 0,56; 95% CI 0,36–0,89). Functional status suggested that all previous smokers were at a higher risk to develop POI compared to lifetime non-smokers (p = 0,0069; RR 1,78; 95% CI 1,17–2,70). Multivariable comparison of ≤ 5 qualifying parameters showed no significance.Conclusion: The high local incidence of POI in this patient population shows that intervention is required to reduce the POI rate and improve postoperative outcomes. This study suggests that for men and all patients with a history of smoking both, CRC resection preoperative recommendations with the intention to prevent POI should include instructions initiating the activation of preventive strategies like the Enhanced Recovery After Surgery (ERAS) programme. More studies are needed to adequately determine local perioperative risk factors for POI.

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Section: Discussionmentioning

confidence: 93%

Men and Those With a History of Smoking Are Associated With the Development of Postoperative Ileus Following Elective Colorectal Cancer Resection at a Private Academic Hospital in Johannesburg, South Africa: A Retrospective Cohort Study

et al. 2021

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“…However, few studies have discussed the association between smoking and POI. Only 1 study found that smoking is associated with postoperative complications after colon resection in diverticulitis patients [10] . To the best of our knowledge, no previous study has included smoking in a multivariate analysis to determine whether it is a risk factor for POI after radical resection of rectal cancer in male patients.…”

Section: Discussionmentioning

confidence: 98%

“…Only 1 study found that smoking is associated with postoperative complications after colon resection in diverticulitis patients. [ 10 ] To the best of our knowledge, no previous study has included smoking in a multivariate analysis to determine whether it is a risk factor for POI after radical resection of rectal cancer in male patients. The present study is the first to show that smoking may be a risk factor for POI after radical rectal cancer resection.…”

Section: Discussionmentioning

confidence: 99%

“…[ 9 ] Study has reported smoking status is associated with POI after colon resection. [ 10 ] Little is known about whether pre-operative smoking effects POI after rectal cancer surgery in male patients. The aim of this study was to examine the association between POI and smoking in a large number of male patients who had undergone radical resection of rectal cancer to determine whether smoking is an independent risk factor for POI.…”

Section: Introductionmentioning

confidence: 99%

“…Only estimated blood loss and total postoperative opiate dosage have been shown to be independent risk factors associated with POI [9] . Study has reported smoking status is associated with POI after colon resection [10] . Little is known about whether pre-operative smoking effects POI after rectal cancer surgery in male patients.…”

Section: Introductionmentioning

confidence: 99%

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Smoking is a risk factor for postoperative ileus after radical resection in male patients

et al. 2021

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Most smokers are males, and smoking has been indicated as a risk factor for many cancers as well as postoperative complications after cancer surgery. However, little is known about whether smoking is a risk factor for postoperative ileus (POI) after radical rectal cancer resection in males. The aim of this study was to assess whether smoking is a risk factor for POI after radical resection in male rectal cancer patients. Data of 1486 patients who underwent radical resection for rectal cancer were extracted from the clinical medical system in our hospital and were statistically analyzed. POI was defined as nausea, vomiting or pain, failure to have bowel function for more than 4 days postoperatively, and absence of a mechanical bowel obstruction. The rate of POI was 12.79%. Univariate analysis showed that patients in the POI group were more likely to have a history of smoking and drinking and receive intraperitoneal chemotherapy and had a larger intraperitoneal chemotherapy dosage. In the multivariable analysis, smoking remained significantly associated with a higher incidence of POI (OR 2.238, 95% CI [1.545–3.240], P = .000). The results also showed that patients who received postoperative patient-controlled intravenous analgesia had a lower incidence of POI. Male patients with a history of smoking who undergo elective radical resection for rectal cancer have an increased risk for POI complications.

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Smoking Status is Associated with Postoperative Ileus after Colon Resection for Diverticular Disease

Cited by 2 publications

References 0 publications

Men and Those With a History of Smoking Are Associated With the Development of Postoperative Ileus Following Elective Colorectal Cancer Resection at a Private Academic Hospital in Johannesburg, South Africa: A Retrospective Cohort Study

Men and Those With a History of Smoking Are Associated With the Development of Postoperative Ileus Following Elective Colorectal Cancer Resection at a Private Academic Hospital in Johannesburg, South Africa: A Retrospective Cohort Study

Smoking is a risk factor for postoperative ileus after radical resection in male patients

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