Department of Surgery (A), Heinrich-Heine-University and University Hospital Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany.
Department of Surgery, Katholisches Klinikum Essen, Philippusstift, Teaching Hospital of Duisburg-Essen University, Huelsmannstrasse 17, 45355, Essen, Germany.
Int J Colorectal Dis. 2023 Oct 2;38(1):244. doi: 10.1007/s00384-023-04538-y.
Postoperative ileus (POI) is a major cause of morbidity in patients undergoing colorectal surgery. The aim of our study was to evaluate potential risk factors for POI in cases with anterior resection for rectal cancer.
A retrospective cohort study was performed on 136 patients who underwent open anterior resection for rectal cancer between 2004 and 2018 at a single tertiary referral center. POI was defined as reinsertion of nasogastric tube or nil per os by postoperative day 4 and/or administration of neostigmine postoperatively. Uni- and multivariate analysis was performed to identify potential risk factors for POI.
POI was observed in 18 patients (13.2%). Epidural anesthesia, type of ostomy, and history of abdominal surgery were not found to be related with POI. Advanced age was a statistically significant risk factor both in the uni- and in the multivariate analyses. An increase in age by 1 year was found to increase the odds of POI by 5% [95%CI: 0.4%-9.7%; p = 0.032].
Increased age was identified as a non-modifiable, patient-related risk factor for POI after anterior resection for rectal cancer. This finding is of particular importance as it turns the focus on the elderly patient and underlines the need for close clinical observation of this subgroup and liberal use of preventive and/or therapeutic measures postoperatively.
术后肠梗阻（POI）是结直肠手术后患者发病的主要原因。我们的研究旨在评估直肠癌前切除术患者 POI 的潜在危险因素。
对 2004 年至 2018 年期间在一家三级转诊中心接受开放性直肠癌前切除术的 136 例患者进行了回顾性队列研究。POI 定义为术后第 4 天重新插入鼻胃管或禁食，和/或术后给予新斯的明。进行单因素和多因素分析以确定 POI 的潜在危险因素。
18 例（13.2%）发生 POI。硬膜外麻醉、造口类型和腹部手术史与 POI 无关。高龄在单因素和多因素分析中均为统计学显著的危险因素。年龄每增加 1 岁，POI 的几率增加 5%[95%CI：0.4%-9.7%；p=0.032]。
年龄增加被确定为直肠癌前切除术后 POI 的不可变的患者相关危险因素。这一发现尤其重要，因为它将关注焦点转移到老年患者身上，并强调需要密切观察这一亚组患者的临床情况，并在术后灵活使用预防性和/或治疗性措施。
Zotero 插件