Increased incidence of prolonged ileus after colectomy for inflammatory bowel diseases under ERAS protocol: a cohort analysis

Abstract Background Postoperative ileus is a common problem after colorectal surgery. The aim of the study was to investigate the incidence and risk factors for prolonged postoperative ileus (POI) after colectomy for inflammatory bowel diseases (IBD). Method Consecutive patients who underwent colore...

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Bibliographic Details
Published in:The Journal of surgical research 2017-05, Vol.212, p.86-93
Main Authors: Dai, Xujie, MD, Ge, Xiaolong, MD, Yang, Jianbo, MD, Zhang, Tenghui, MD, Xie, Tingbin, MD, Gao, Wen, MD, Gong, Jianfeng, MD, Zhu, Weiming, MD
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Clinical Protocols
Colectomy
Colorectal cancer
Colorectal Neoplasms - surgery
Colorectal surgery
Enhanced recovery after surgery
Female
Humans
Ileus - epidemiology
Ileus - etiology
Incidence
Inflammatory bowel diseases
Inflammatory Bowel Diseases - surgery
Logistic Models
Male
Middle Aged
Perioperative Care - methods
Postoperative Complications - epidemiology
Postoperative Complications - etiology
Postoperative ileus
Retrospective Studies
Risk Factors
Surgery
Treatment Outcome
Young Adult
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Summary:Abstract Background Postoperative ileus is a common problem after colorectal surgery. The aim of the study was to investigate the incidence and risk factors for prolonged postoperative ileus (POI) after colectomy for inflammatory bowel diseases (IBD). Method Consecutive patients who underwent colorectal resection for IBD vs. colorectal cancer (CRC) patients under enhanced recovery after surgery (ERAS) protocol were retrospectively analyzed. Primary assessment endpoint is the incidence of prolonged POI (> 4 days); secondary endpoints were GI-2 recovery (time to first toleration of solid food and first bowel movement), nasogastric tube re-insertion, and postoperative length of stay. Risk factors for prolonged POI in IBD patients were assessed by multiple logistic regression analysis with p-score matching. Results The incidence of prolonged POI was higher in IBD vs. CRC group (28.8 vs. 14.8%, P < 0.001). Patients with IBD had a longer time to GI-2 recovery (4.8±2.1 vs 3.7 ± 1.4 d, P < 0.001), postoperative length of stay (10.7 ± 6.2 vs. 7.9 ± 5.3 d, P < 0.001), higher incidence of nasogastric tube re-insertion (9.8 vs. 4.0%, P = 0.02). After propensity-score matching analysis, the differences were still significant. Preoperative steroid use > 20mg/d (OR = 2.19, P =0.048), hypo-albuminemia (
ISSN:0022-4804
1095-8673
DOI:10.1016/j.jss.2016.12.031