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World Journal of Surgery

, Volume 38, Issue 11, pp 3007–3014 | Cite as

Early Postoperative Small Bowel Obstruction is an Independent Risk Factor for Subsequent Adhesive Small Bowel Obstruction in Patients Undergoing Open Colectomy

  • Soo Young Lee
  • Kyu Joo Park
  • Seung-Bum Ryoo
  • Heung-Kwon Oh
  • Eun Kyung Choe
  • Seung Chul HeoEmail author
Original Scientific Report

Abstract

Background

This prospective study was performed to investigate whether postoperative ileus (POI) or early postoperative small bowel obstruction (EPSBO) affects the development of adhesive small bowel obstruction (SBO) in patients undergoing colectomy.

Methods

We prospectively enrolled 1,002 patients who underwent open colectomy by a single surgeon. POI was defined as the absence of bowel function for more than 5 days or as a delay in oral intake beyond 7 days postoperatively. EPSBO was defined as the clinical and radiologic identification of SBO after resuming oral intake between postoperative days 7 and 30. Adhesive SBO was defined as SBO developing after 30 days because of intraperitoneal adhesion. The associations between POI, EPSBO, patient- and surgery-related variables, and the development of adhesive SBO were analyzed.

Results

A total of 85 (8.5 %) patients developed POI, and 42 patients (4.2 %) developed EPSBO, with seven patients experiencing both POI and EPSBO. During the follow-up period (median 51 months), 70 patients (7.0 %) developed adhesive SBO, six (8.6 %) of whom needed laparotomy. The occurrence of adhesive SBO was significantly higher in patients with EPSBO than in those without EPSBO (26.5 vs. 7.5 % at 5 years, P < 0.001), but not in patients with POI (13.4 vs. 7.8 % at 5 years, P = 0.158). Multivariable analysis showed colostomy (hazard ratio [HR] 2.530, P = 0.006) and EPSBO (HR 4.063, P < 0.001) as independent risk factors for adhesive SBO.

Conclusions

The development of adhesive SBO after colectomy is more frequent in patients with EPSBO and colostomy; however, POI does not increase the risk of adhesive SBO.

Keywords

Small Bowel Obstruction Ileal Pouch Subtotal Colectomy Open Colectomy Pseudomyxoma Peritonei 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Conflicts of interest

The authors received no commercial support for this study. The authors declare no conflicts of interest.

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Copyright information

© Société Internationale de Chirurgie 2014

Authors and Affiliations

  • Soo Young Lee
    • 1
  • Kyu Joo Park
    • 2
  • Seung-Bum Ryoo
    • 2
  • Heung-Kwon Oh
    • 1
  • Eun Kyung Choe
    • 3
  • Seung Chul Heo
    • 4
    Email author
  1. 1.Department of SurgerySeoul National University Bundang HospitalSeongnamKorea
  2. 2.Department of SurgerySeoul National University HospitalSeoulKorea
  3. 3.Department of SurgerySeoul National University Hospital Healthcare System Gangnam CenterSeoulKorea
  4. 4.Department of SurgerySeoul National University College of Medicine, Seoul Metropolitan Government Boramae HospitalSeoulKorea

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