Kim Chul Jang, Sano Taichi, Tomita Keiji, Takimoto Keita
The Department of Urology, Kohka Public Hospital, Japan.
Hinyokika Kiyo. 2011 Oct;57(10):535-8.
To identify the incidence and risk factors for developing early postoperative paralytic ileus (POPI) after radical cystectomy and cutaneous ureterostomy with a unilateral and parallel stoma, we retrospectively reviewed 21 patients (mean age 73.0, 19 males and 2 females) with a minimum of 3 months of follow-up. POPI occurred in 4 patients (19.0%), who did not need surgical treatment and the insertion of a nasogastric tube. Age and past history of abdominal surgery influenced the occurrence of POPI. The patients with and without POPI had a mean age of 82.3±7.4 and 70.8±6.3 years old, respectively (p＝0.0025), and 75.0% (3/4) and 11.8% (2/17) of the patients, respectively, had a past history of abdominal surgery (p＝ 0.0276). There were no significant differences between patients with and without POPI in any of the following factors examined : sex, body mass index, American Society of Anesthesiologists score, pT-category, neoadjuvant chemotherapy, preoperative serum levels of hemoglobin, creatinine, total protein, and albumin, operative time, blood loss, transfusion volume, stomal side, postoperative day of ambulation, and removal of epidural anesthesia tube. In conclusion, our results showed that increasing age and a past history of abdominal surgery were significantly associated with the occurrence of POPI after radical cystectomy and cutaneous ureterostomy.
为了确定根治性膀胱切除术和单侧平行造口皮肤输尿管造口术后早期发生术后麻痹性肠梗阻（POPI）的发生率及危险因素，我们回顾性分析了21例患者（平均年龄73.0岁，19例男性，2例女性），随访时间至少3个月。4例患者（19.0%）发生了POPI，这些患者无需手术治疗及插入鼻胃管。年龄和腹部手术史会影响POPI的发生。发生POPI和未发生POPI的患者平均年龄分别为82.3±7.4岁和70.8±6.3岁（p＝0.0025），分别有75.0%（3/4）和11.8%（2/17）的患者有腹部手术史（p＝0.0276）。在以下所检查的任何因素方面，发生POPI和未发生POPI的患者之间均无显著差异：性别、体重指数、美国麻醉医师协会评分、pT分期、新辅助化疗、术前血清血红蛋白、肌酐、总蛋白和白蛋白水平、手术时间、失血量、输血量、造口侧、术后下床活动天数及拔除硬膜外麻醉导管的时间。总之，我们的结果表明，年龄增加和腹部手术史与根治性膀胱切除术和皮肤输尿管造口术后POPI的发生显著相关。
