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Risk factors for postoperative ileus following elective laparoscopic right colectomy: a retrospective multicentric study

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

Postoperative ileus (POI) is associated with an elevated risk of other complications and increases the economic impact on healthcare services. The aim of this study was to identify pre-, intra- and postoperative risk factors associated with the development of POI following elective laparoscopic right colectomy.

Methods

Between 2004 and 2016, 637 laparoscopic right colectomies were performed. Data were analysed retrospectively thanks to the CLIHMET database. Potential contributing factors were analysed by logistic regression.

Results

Patients with POI (n = 113, 17.7%) were compared to those without postoperative ileus (WPOI) (n = 524, 82.3%). In the POI group, there were more men (62 vs 49%; p = 0.012), more use of epidural anaesthesia (19 vs 9%; p = 0.004), more intraoperative blood transfusion requirements (7 vs 3%; p = 0.018) and greater perioperative intravenous fluid administration (2000 vs 1750 mL; p < 0.001). POIs were more frequent when extracorporeal vascular section (20 vs 12%; p = 0.049) and transversal incision for extraction site (34 vs 23%; p = 0.044) were performed. Overall surgical complications in the POI group were significantly greater than in the control group WPOI (31.9 vs 12.0%; p < 0.0001). Multivariate analysis found the following independent POI risk factors: male gender (HR = 2.316, 1.102–4.866), epidural anaesthesia (HR = 2.958, 1.250–6.988) and postoperative blood transfusion requirement (HR = 6.994, 1.550–31.560).

Conclusions

This study is one of the first to explore the CLIHMET database and the first to use it for investigating risk factors for POI development. Modifiable risk factors such as epidural anaesthesia and intraoperative blood transfusion should be used with caution in order to decrease POI rates.

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Authors and Affiliations

  1. Department of Digestive, Oncological, Endocrine and Hepatic Surgery and Hepatic Transplantation, Colorectal Surgery Unit, Trousseau Hospital, Avenue de la République, Chambray les Tours, Tours, France

    Lise Courtot, Nicolas Tabchouri, Ephrem Salamé & Mehdi Ouaïssi

  2. Department of Digestive Surgery, Estaing University Hospital, Clermont-Ferrand, France

    Bertrand Le Roy, Johan Gagniere & Denis Pezet

  3. Hepato-Biliary and Pancreatic Surgical Unit, IRCAD-IHU, University of Strasbourg, Strasbourg, France

    Ricardo Memeo & Didier Mutter

  4. Department of Digestive Surgery, George Pompidou European Hospital, Paris, France

    Thibault Voron & Anne Berger

  5. Department of Digestive Surgery, Hepato-Pancreato-Biliary Surgery, and Liver Transplantation, Henri-Mondor Hospital, AP-HP, Créteil, Paris, France

    Nicolas de Angelis & Francesco Brunetti

Authors
  1. Lise Courtot
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  2. Bertrand Le Roy
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  3. Ricardo Memeo
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Correspondence to Mehdi Ouaïssi.

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Courtot, L., Le Roy, B., Memeo, R. et al. Risk factors for postoperative ileus following elective laparoscopic right colectomy: a retrospective multicentric study. Int J Colorectal Dis 33, 1373–1382 (2018). https://doi.org/10.1007/s00384-018-3070-2

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  • DOI: https://doi.org/10.1007/s00384-018-3070-2

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