Bureta Costansia, Tominaga Hiroyuki, Yamamoto Takuya, Kawamura Ichiro, Abematsu Masahiko, Yone Kazunori, Komiya Setsuro
Department of Orthopaedic Surgery, Kagoshima University, Kagoshima, Japan.
Department of Neurosurgery, Muhimbili Orthopaedic and Neurosurgical Institute, Dar es Salaam, Tanzania.
Spine Surg Relat Res. 2018 Mar 15;2(3):226-229. doi: 10.22603/ssrr.2017-0057. eCollection 2018.
One complication after scoliosis surgery is ileus; however, few reports have described the frequency of and risk factors for this complication. We conducted a retrospective clinical study with logistic regression analysis to confirm the frequency of and risk factors for ileus after scoliosis surgery.
After a retrospective review of data from patients who underwent surgical correction of spinal deformity from 2009 to 2014, 110 cases (age range, 4-73 yr; median, 14 yr) were included in the study. We defined postoperative ileus (POI) as a surgical complication characterized by decreased intestinal peristalsis and the absence of stool for more than 3 days postoperatively. Various parameters were compared between patients with POI and those without POI. Logistic regression analysis was performed to assess the risk factors associated with ileus; a value of <0.05 was considered statistically significant.
Fifteen of 110 (13.6%) cases developed POI. The median height, weight, operation time, and blood loss volume of the patients with versus without POI were 146 versus 152 cm, 39.0 versus 44.0 kg, 387 versus 359 min, and 1590 versus 1170 g, respectively. There were no significant differences between patients with versus without POI in the measured parameters, with the exception of patient height, bed rest period, and presence of neuromuscular scoliosis. Multiple logistic regression analysis revealed neuromuscular scoliosis as a significant risk factor for POI (odds ratio, 4.21; 95% CI, 1.23-14.40).
Our findings indicate a high probability of POI after scoliosis surgery, with an incidence of 13.6%. Neurogenic scoliosis, but not lowest instrumented vertebra or correction rate, was a risk factor for POI after scoliosis surgery. Digestive symptoms should be carefully monitored after surgery, particularly in patients with neuromuscular scoliosis.
脊柱侧弯手术后的一种并发症是肠梗阻；然而，很少有报告描述这种并发症的发生率和危险因素。我们进行了一项回顾性临床研究，并采用逻辑回归分析来确定脊柱侧弯手术后肠梗阻的发生率和危险因素。
在对2009年至2014年接受脊柱畸形手术矫正的患者数据进行回顾性分析后，110例患者（年龄范围4 - 73岁；中位数14岁）被纳入研究。我们将术后肠梗阻（POI）定义为一种手术并发症，其特征为术后肠道蠕动减弱且无排便超过3天。对发生POI的患者和未发生POI的患者之间的各种参数进行了比较。进行逻辑回归分析以评估与肠梗阻相关的危险因素；P值<0.05被认为具有统计学意义。
110例患者中有15例（13.6%）发生了POI。发生POI与未发生POI的患者的中位身高、体重、手术时间和失血量分别为146 cm对152 cm、39.0 kg对44.0 kg、387分钟对359分钟以及1590 g对1170 g。除患者身高、卧床时间和神经肌肉型脊柱侧弯外，发生POI与未发生POI的患者在测量参数方面无显著差异。多因素逻辑回归分析显示神经肌肉型脊柱侧弯是POI的一个显著危险因素（比值比，4.21；95%可信区间，1.23 - 14.40）。
我们的研究结果表明脊柱侧弯手术后发生POI的可能性较高，发生率为13.6%。神经源性脊柱侧弯而非最低融合椎体或矫正率是脊柱侧弯手术后POI的一个危险因素。术后应仔细监测消化症状，尤其是神经肌肉型脊柱侧弯患者。
