Yilmaz Emre, Benca Eric, Patel Akil P, Hopkins Sarah, Blecher Ronen, Abdul-Jabbar Amir, O'Lynnger Thomas M, Oskouian Rod J, Norvell Daniel C, Chapman Jens
Swedish Neuroscience Institute, 187868Swedish Medical Center, Seattle, WA, USA.
Seattle Science Foundation, Seattle, WA, USA.
Global Spine J. 2022 Sep;12(7):1407-1411. doi: 10.1177/2192568220981971. Epub 2021 Jan 12.
Case-Control Study.
The purpose of this retrospective study is to evaluate risk factors for developing a postoperative ileus after posterior spine surgery.
Patient charts, including radiographs were evaluated retrospectively. Diagnosis of an ileus was confirmed radiographically by a CT scan in all cases. The control group was retrieved by selecting a random sample of patients undergoing posterior spine surgery who did not develop bowel dysfunction postoperatively.
A total of 40 patients had a postoperative ileus. The control group consisted of 80 patients. Both groups did not differ significantly in age, gender, BMI, tobacco use, comorbidities or status of previous abdominal surgery. Significant differences between the 2 groups was the length of stay (5.9 vs. 11.2; p = 0.001), surgery in the lumbar spine (47.5% vs. 87.5%; p < 0.001) and major spine surgery involving > 3 levels (35.0% vs. 57.5%; p = 0.019). Patients who suffered from an ileus were more likely to be treated in ICU (23.8% vs. 37.5%; p = 0.115), being re-admitted (0.0% vs 5.0%; p = 0.044) and having a delayed discharge (32.5% vs. 57.5%; p = 0.009). Multivariable analysis demonstrated that lumbar spine surgery compared to thoracic and/or cervical spine surgery (p = 0.00, OR 8.7 CI 2.9-25.4) and major spine surgery involving > 3 levels (p = 0.012; OR 3.0, CI 1.3-7.2) are associated with developing an ileus postoperatively.
Surgeries of the lumbar spine as well as those involving > 3 levels are associated with developing a postoperative ileus. Further studies are needed to expand on possible risk factors and to better understand the mechanism underlying postoperative ileus in spine surgery patients.
病例对照研究。
这项回顾性研究的目的是评估后路脊柱手术后发生术后肠梗阻的危险因素。
对包括X光片在内的患者病历进行回顾性评估。所有病例均通过CT扫描在影像学上确诊为肠梗阻。对照组通过随机抽取接受后路脊柱手术且术后未出现肠道功能障碍的患者获得。
共有40例患者发生术后肠梗阻。对照组由80例患者组成。两组在年龄、性别、体重指数、吸烟情况、合并症或既往腹部手术状况方面无显著差异。两组之间的显著差异在于住院时间（5.9天对11.2天；p = 0.001）、腰椎手术（47.5%对87.5%；p < 0.001）以及涉及超过3个节段的大型脊柱手术（35.0%对57.5%；p = 0.019）。发生肠梗阻的患者更有可能在重症监护病房接受治疗（23.8%对37.5%；p = 0.115）、再次入院（0.0%对5.0%；p = 0.044）以及延迟出院（32.5%对57.5%；p = 0.009）。多变量分析表明，与胸椎和/或颈椎手术相比，腰椎手术（p = 0.00，比值比8.7，置信区间2.9 - 25.4）以及涉及超过3个节段的大型脊柱手术（p = 0.012；比值比3.0，置信区间1.3 - 7.2）与术后发生肠梗阻相关。
腰椎手术以及涉及超过3个节段的手术与术后肠梗阻的发生相关。需要进一步研究以扩展可能的危险因素，并更好地理解脊柱手术患者术后肠梗阻的潜在机制。
