Department of Colorectal Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, Ohio, USA.
Department of Colorectal Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, Ohio, USA.
Am J Surg. 2020 Mar;219(3):527-529. doi: 10.1016/j.amjsurg.2019.10.002. Epub 2019 Oct 5.
Ileus following colorectal surgery is a significant burden for healthcare and can be challenging to manage. This study aims to evaluate risk factors for postoperative ileus in patients undergoing colorectal surgery.
Patients who underwent colorectal resections for any diagnosis were identified from our institutional database between 2009 and 2014. Patient demographics, pre-operative comorbidities, and operation-related variables were compared in patients with and without ileus within 30 days after surgery.
A total of 5369 patients were identified with a mean age of 53 years. 892 patients (16.6%) developed postoperative ileus. Males were twice as likely (p < 0.001) and patients with anastomosis were 1.4 times more likely to develop ileus compared to those without (p < 0.001). Laparoscopic surgery and younger age were associated with lower ileus risk. Patients with colorectal cancer, Crohn's disease, and ulcerative colitis diagnoses were all more likely to develop postoperative ileus compared to patients with diverticular disease.
Evaluation of factors such as male gender, older age, anastomosis formation, diagnosis of cancer and inflammatory bowel disease, can help facilitate earlier diagnosis of postoperative ileus and may require consideration of prophylactic therapy.
结直肠手术后的肠梗阻是医疗保健的重大负担，且难以处理。本研究旨在评估接受结直肠手术的患者术后发生肠梗阻的风险因素。
从我们的机构数据库中确定了 2009 年至 2014 年间因任何诊断而行结直肠切除术的患者。比较了手术后 30 天内发生和未发生肠梗阻的患者的患者人口统计学、术前合并症和手术相关变量。
共确定了 5369 名患者，平均年龄为 53 岁。892 名患者（16.6%）发生术后肠梗阻。男性发生肠梗阻的可能性是女性的两倍（p<0.001），且与无吻合术的患者相比，有吻合术的患者发生肠梗阻的可能性高 1.4 倍（p<0.001）。腹腔镜手术和较年轻的年龄与较低的肠梗阻风险相关。与憩室病患者相比，患有结直肠癌、克罗恩病和溃疡性结肠炎的患者更易发生术后肠梗阻。
评估男性、年龄较大、吻合术形成、癌症和炎症性肠病的诊断等因素，有助于更早地诊断术后肠梗阻，可能需要考虑预防性治疗。
