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Ileus rate after abdominal wall reconstruction: a retrospective analysis of two clinical trials
Purpose Postoperative ileus (POI) is the paralytic disruption of gastrointestinal motility, a common complication following abdominal wall reconstruction that often leads to increased patient morbidity and length of stay (LOS). We reviewed two randomized clinical trials to determine POI rates, predi...
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| Published in: | Hernia : the journal of hernias and abdominal wall surgery 2022-12, Vol.26 (6), p.1591-1598 |
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| container_title | Hernia : the journal of hernias and abdominal wall surgery |
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| creator | Greco, C. D. Petro, C. C. Thomas, J. D. Montelione, K. Tu, C. Fafaj, A. Zolin, S. Krpata, D. Rosenblatt, S. Rosen, M. Beffa, L. Prabhu, A. |
| description | Purpose
Postoperative ileus (POI) is the paralytic disruption of gastrointestinal motility, a common complication following abdominal wall reconstruction that often leads to increased patient morbidity and length of stay (LOS). We reviewed two randomized clinical trials to determine POI rates, predictive factors, LOS, and associated cost.
Methods
Two randomized trials were performed from 2017–2019 with all patients receiving elective open abdominal wall reconstruction with retromuscular mesh. Using multivariate logistic regression, we performed a retrospective analysis including demographics and operative details from patients at a single site to determine predictive factors for POI. All medical costs encompassing surgery and the 30-day postoperative period were compared between ileus and non-ileus groups.
Results
Four hundred and seventy patients were reviewed with a POI rate of 13.0% (
N
= 61). There were no differences in age, body mass index (BMI), history of abdominal surgery, or comorbidities between patients with and without POI. Logistic regression showed no association with POI and age, BMI, hernia width, or operative time lasting longer than 4 h. Median LOS was 8 days for patients with POI compared to five for those without (
p |
| doi_str_mv | 10.1007/s10029-022-02687-7 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2731429517</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2731429517</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-8ab56bf5292e3cce5322f81da24d6ccd5271b63036be17dca2bb8f8e7f9d41303</originalsourceid><addsrcrecordid>eNp9kEtPAyEUhYnR2Fr9Ay4MiRs3ozxmYHBnGh9NmrjRNWEYxkwzHSowNv333rY-Ehcu4JLLdw7cg9A5JdeUEHkTYWcqI4zBEqXM5AEaU5aXmWIkP9yeRZHliogROolxQQgpc1EeoxEXnCpFyBjpWeeGiINJDpsmuYBNVftl25sOr03X4eCs72MKg02t72-xgU4KPq4cND5ABOQmthH7Bqe1x7Zr-9aCOoXWdPEUHTVQ3NlXnaDXh_uX6VM2f36cTe_mmeWySFlpqkJUTcEUc9xaV3DGmpLWhuW1sLYumKSV4ISLylFZW8OqqmxKJxtV5xT6E3S1910F_z64mPSyjdZ1nemdH6JmktOcqYJKQC__oAs_BBhjRyn4gsg5UGxPWRg2BtfoVWiXJmw0JXobv97HryF-vYtfb60vvqyHaunqH8l33gDwPRDhqn9z4fftf2w_AU-okPI</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2739292643</pqid></control><display><type>article</type><title>Ileus rate after abdominal wall reconstruction: a retrospective analysis of two clinical trials</title><source>Springer Nature</source><creator>Greco, C. D. ; Petro, C. C. ; Thomas, J. D. ; Montelione, K. ; Tu, C. ; Fafaj, A. ; Zolin, S. ; Krpata, D. ; Rosenblatt, S. ; Rosen, M. ; Beffa, L. ; Prabhu, A.</creator><creatorcontrib>Greco, C. D. ; Petro, C. C. ; Thomas, J. D. ; Montelione, K. ; Tu, C. ; Fafaj, A. ; Zolin, S. ; Krpata, D. ; Rosenblatt, S. ; Rosen, M. ; Beffa, L. ; Prabhu, A.</creatorcontrib><description>Purpose
Postoperative ileus (POI) is the paralytic disruption of gastrointestinal motility, a common complication following abdominal wall reconstruction that often leads to increased patient morbidity and length of stay (LOS). We reviewed two randomized clinical trials to determine POI rates, predictive factors, LOS, and associated cost.
Methods
Two randomized trials were performed from 2017–2019 with all patients receiving elective open abdominal wall reconstruction with retromuscular mesh. Using multivariate logistic regression, we performed a retrospective analysis including demographics and operative details from patients at a single site to determine predictive factors for POI. All medical costs encompassing surgery and the 30-day postoperative period were compared between ileus and non-ileus groups.
Results
Four hundred and seventy patients were reviewed with a POI rate of 13.0% (
N
= 61). There were no differences in age, body mass index (BMI), history of abdominal surgery, or comorbidities between patients with and without POI. Logistic regression showed no association with POI and age, BMI, hernia width, or operative time lasting longer than 4 h. Median LOS was 8 days for patients with POI compared to five for those without (
p
< 0.001). Relative median 30-day costs were 1.19 in patients with ileus and 1.0 in those without (
p
< 0.001).
Conclusion
We identified a 13% rate of POI in patients undergoing open abdominal wall reconstruction with mesh with no clearly identified predisposing factors. This resulted in a 3 days increase in median LOS and 19% additional costs. Further efforts should be devoted to investigating interventions that may reduce postoperative ileus after abdominal wall reconstruction.</description><identifier>ISSN: 1265-4906</identifier><identifier>ISSN: 1248-9204</identifier><identifier>EISSN: 1248-9204</identifier><identifier>DOI: 10.1007/s10029-022-02687-7</identifier><identifier>PMID: 36319900</identifier><language>eng</language><publisher>Paris: Springer Paris</publisher><subject>Abdomen ; Abdominal Surgery ; Abdominal wall ; Abdominal Wall - surgery ; Body mass index ; Clinical trials ; Clinical Trials as Topic ; Comorbidity ; Costs ; Gastric motility ; Hernia ; Herniorrhaphy - adverse effects ; Humans ; Ileus - etiology ; Medicine ; Medicine & Public Health ; Morbidity ; Original Article ; Patients ; Postoperative Complications - etiology ; Regression analysis ; Retrospective Studies ; Risk Factors ; Surgery ; Surgical mesh</subject><ispartof>Hernia : the journal of hernias and abdominal wall surgery, 2022-12, Vol.26 (6), p.1591-1598</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature 2022. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2022. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-8ab56bf5292e3cce5322f81da24d6ccd5271b63036be17dca2bb8f8e7f9d41303</citedby><cites>FETCH-LOGICAL-c375t-8ab56bf5292e3cce5322f81da24d6ccd5271b63036be17dca2bb8f8e7f9d41303</cites><orcidid>0000-0003-1343-9250</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27923,27924</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36319900$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Greco, C. D.</creatorcontrib><creatorcontrib>Petro, C. C.</creatorcontrib><creatorcontrib>Thomas, J. D.</creatorcontrib><creatorcontrib>Montelione, K.</creatorcontrib><creatorcontrib>Tu, C.</creatorcontrib><creatorcontrib>Fafaj, A.</creatorcontrib><creatorcontrib>Zolin, S.</creatorcontrib><creatorcontrib>Krpata, D.</creatorcontrib><creatorcontrib>Rosenblatt, S.</creatorcontrib><creatorcontrib>Rosen, M.</creatorcontrib><creatorcontrib>Beffa, L.</creatorcontrib><creatorcontrib>Prabhu, A.</creatorcontrib><title>Ileus rate after abdominal wall reconstruction: a retrospective analysis of two clinical trials</title><title>Hernia : the journal of hernias and abdominal wall surgery</title><addtitle>Hernia</addtitle><addtitle>Hernia</addtitle><description>Purpose
Postoperative ileus (POI) is the paralytic disruption of gastrointestinal motility, a common complication following abdominal wall reconstruction that often leads to increased patient morbidity and length of stay (LOS). We reviewed two randomized clinical trials to determine POI rates, predictive factors, LOS, and associated cost.
Methods
Two randomized trials were performed from 2017–2019 with all patients receiving elective open abdominal wall reconstruction with retromuscular mesh. Using multivariate logistic regression, we performed a retrospective analysis including demographics and operative details from patients at a single site to determine predictive factors for POI. All medical costs encompassing surgery and the 30-day postoperative period were compared between ileus and non-ileus groups.
Results
Four hundred and seventy patients were reviewed with a POI rate of 13.0% (
N
= 61). There were no differences in age, body mass index (BMI), history of abdominal surgery, or comorbidities between patients with and without POI. Logistic regression showed no association with POI and age, BMI, hernia width, or operative time lasting longer than 4 h. Median LOS was 8 days for patients with POI compared to five for those without (
p
< 0.001). Relative median 30-day costs were 1.19 in patients with ileus and 1.0 in those without (
p
< 0.001).
Conclusion
We identified a 13% rate of POI in patients undergoing open abdominal wall reconstruction with mesh with no clearly identified predisposing factors. This resulted in a 3 days increase in median LOS and 19% additional costs. Further efforts should be devoted to investigating interventions that may reduce postoperative ileus after abdominal wall reconstruction.</description><subject>Abdomen</subject><subject>Abdominal Surgery</subject><subject>Abdominal wall</subject><subject>Abdominal Wall - surgery</subject><subject>Body mass index</subject><subject>Clinical trials</subject><subject>Clinical Trials as Topic</subject><subject>Comorbidity</subject><subject>Costs</subject><subject>Gastric motility</subject><subject>Hernia</subject><subject>Herniorrhaphy - adverse effects</subject><subject>Humans</subject><subject>Ileus - etiology</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Morbidity</subject><subject>Original Article</subject><subject>Patients</subject><subject>Postoperative Complications - etiology</subject><subject>Regression analysis</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Surgery</subject><subject>Surgical mesh</subject><issn>1265-4906</issn><issn>1248-9204</issn><issn>1248-9204</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><recordid>eNp9kEtPAyEUhYnR2Fr9Ay4MiRs3ozxmYHBnGh9NmrjRNWEYxkwzHSowNv333rY-Ehcu4JLLdw7cg9A5JdeUEHkTYWcqI4zBEqXM5AEaU5aXmWIkP9yeRZHliogROolxQQgpc1EeoxEXnCpFyBjpWeeGiINJDpsmuYBNVftl25sOr03X4eCs72MKg02t72-xgU4KPq4cND5ABOQmthH7Bqe1x7Zr-9aCOoXWdPEUHTVQ3NlXnaDXh_uX6VM2f36cTe_mmeWySFlpqkJUTcEUc9xaV3DGmpLWhuW1sLYumKSV4ISLylFZW8OqqmxKJxtV5xT6E3S1910F_z64mPSyjdZ1nemdH6JmktOcqYJKQC__oAs_BBhjRyn4gsg5UGxPWRg2BtfoVWiXJmw0JXobv97HryF-vYtfb60vvqyHaunqH8l33gDwPRDhqn9z4fftf2w_AU-okPI</recordid><startdate>20221201</startdate><enddate>20221201</enddate><creator>Greco, C. D.</creator><creator>Petro, C. C.</creator><creator>Thomas, J. D.</creator><creator>Montelione, K.</creator><creator>Tu, C.</creator><creator>Fafaj, A.</creator><creator>Zolin, S.</creator><creator>Krpata, D.</creator><creator>Rosenblatt, S.</creator><creator>Rosen, M.</creator><creator>Beffa, L.</creator><creator>Prabhu, A.</creator><general>Springer Paris</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-1343-9250</orcidid></search><sort><creationdate>20221201</creationdate><title>Ileus rate after abdominal wall reconstruction: a retrospective analysis of two clinical trials</title><author>Greco, C. D. ; Petro, C. C. ; Thomas, J. D. ; Montelione, K. ; Tu, C. ; Fafaj, A. ; Zolin, S. ; Krpata, D. ; Rosenblatt, S. ; Rosen, M. ; Beffa, L. ; Prabhu, A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-8ab56bf5292e3cce5322f81da24d6ccd5271b63036be17dca2bb8f8e7f9d41303</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Abdomen</topic><topic>Abdominal Surgery</topic><topic>Abdominal wall</topic><topic>Abdominal Wall - surgery</topic><topic>Body mass index</topic><topic>Clinical trials</topic><topic>Clinical Trials as Topic</topic><topic>Comorbidity</topic><topic>Costs</topic><topic>Gastric motility</topic><topic>Hernia</topic><topic>Herniorrhaphy - adverse effects</topic><topic>Humans</topic><topic>Ileus - etiology</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Morbidity</topic><topic>Original Article</topic><topic>Patients</topic><topic>Postoperative Complications - etiology</topic><topic>Regression analysis</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Surgery</topic><topic>Surgical mesh</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Greco, C. D.</creatorcontrib><creatorcontrib>Petro, C. C.</creatorcontrib><creatorcontrib>Thomas, J. D.</creatorcontrib><creatorcontrib>Montelione, K.</creatorcontrib><creatorcontrib>Tu, C.</creatorcontrib><creatorcontrib>Fafaj, A.</creatorcontrib><creatorcontrib>Zolin, S.</creatorcontrib><creatorcontrib>Krpata, D.</creatorcontrib><creatorcontrib>Rosenblatt, S.</creatorcontrib><creatorcontrib>Rosen, M.</creatorcontrib><creatorcontrib>Beffa, L.</creatorcontrib><creatorcontrib>Prabhu, A.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Hernia : the journal of hernias and abdominal wall surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Greco, C. D.</au><au>Petro, C. C.</au><au>Thomas, J. D.</au><au>Montelione, K.</au><au>Tu, C.</au><au>Fafaj, A.</au><au>Zolin, S.</au><au>Krpata, D.</au><au>Rosenblatt, S.</au><au>Rosen, M.</au><au>Beffa, L.</au><au>Prabhu, A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Ileus rate after abdominal wall reconstruction: a retrospective analysis of two clinical trials</atitle><jtitle>Hernia : the journal of hernias and abdominal wall surgery</jtitle><stitle>Hernia</stitle><addtitle>Hernia</addtitle><date>2022-12-01</date><risdate>2022</risdate><volume>26</volume><issue>6</issue><spage>1591</spage><epage>1598</epage><pages>1591-1598</pages><issn>1265-4906</issn><issn>1248-9204</issn><eissn>1248-9204</eissn><abstract>Purpose
Postoperative ileus (POI) is the paralytic disruption of gastrointestinal motility, a common complication following abdominal wall reconstruction that often leads to increased patient morbidity and length of stay (LOS). We reviewed two randomized clinical trials to determine POI rates, predictive factors, LOS, and associated cost.
Methods
Two randomized trials were performed from 2017–2019 with all patients receiving elective open abdominal wall reconstruction with retromuscular mesh. Using multivariate logistic regression, we performed a retrospective analysis including demographics and operative details from patients at a single site to determine predictive factors for POI. All medical costs encompassing surgery and the 30-day postoperative period were compared between ileus and non-ileus groups.
Results
Four hundred and seventy patients were reviewed with a POI rate of 13.0% (
N
= 61). There were no differences in age, body mass index (BMI), history of abdominal surgery, or comorbidities between patients with and without POI. Logistic regression showed no association with POI and age, BMI, hernia width, or operative time lasting longer than 4 h. Median LOS was 8 days for patients with POI compared to five for those without (
p
< 0.001). Relative median 30-day costs were 1.19 in patients with ileus and 1.0 in those without (
p
< 0.001).
Conclusion
We identified a 13% rate of POI in patients undergoing open abdominal wall reconstruction with mesh with no clearly identified predisposing factors. This resulted in a 3 days increase in median LOS and 19% additional costs. Further efforts should be devoted to investigating interventions that may reduce postoperative ileus after abdominal wall reconstruction.</abstract><cop>Paris</cop><pub>Springer Paris</pub><pmid>36319900</pmid><doi>10.1007/s10029-022-02687-7</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-1343-9250</orcidid></addata></record> |
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| ispartof | Hernia : the journal of hernias and abdominal wall surgery, 2022-12, Vol.26 (6), p.1591-1598 |
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| subjects | Abdomen Abdominal Surgery Abdominal wall Abdominal Wall - surgery Body mass index Clinical trials Clinical Trials as Topic Comorbidity Costs Gastric motility Hernia Herniorrhaphy - adverse effects Humans Ileus - etiology Medicine Medicine & Public Health Morbidity Original Article Patients Postoperative Complications - etiology Regression analysis Retrospective Studies Risk Factors Surgery Surgical mesh |
| title | Ileus rate after abdominal wall reconstruction: a retrospective analysis of two clinical trials |
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