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Incidence and risk factors of postoperative ileus after hysterectomy for benign indications

International Journal of Colorectal Disease volume 35, pages 2105–2112 (2020)Cite this article

Abstract

Purpose

Postoperative ileus (POI) after abdominal surgery is associated with prolonged hospital stay and increased costs. The aim of this study is to investigate the incidence of, risk factors for, and outcomes associated with POI in patients undergoing hysterectomy for benign indications.

Methods

A retrospective review of 1017 consecutive patients undergoing benign hysterectomy over the period 2012–2017 in a single center was performed. POI was predefined as absence of flatus and defecation for more than 2 days with the presence of one or more of the following symptoms: nausea, vomiting, and abdominal distention. The association between perioperative variables and the risk of POI was evaluated by univariate analysis. Independent risk factors were identified by multivariate logistic regression analysis.

Results

Overall incidence of POI was 9.2%. Incidence of POI did not differ significantly among three different surgical approaches (abdominal hysterectomy, 10.6%; laparoscopic hysterectomy, 7.8%; vaginal hysterectomy, 11.3%; P = 0.279). Independent risk factors of POI identified by multivariate analysis included anesthesia technique (odds ratio [OR] 2.662, 95% interval [CI] 1.533–4.622, P = 0.001), adhesiolysis (odds ratio [OR] 1.818, 95% interval [CI] 1.533–4.622, P = 0.011), duration of operation (odds ratio [OR] 1.005, 95% interval [CI] 0.942–6.190, P = 0.029), previous cancer (odds ratio [OR] 4.789, 95% interval [CI] 1.232–18.626, P = 0.024), and dysmenorrhea (odds ratio [OR] 1.859, 95% interval [CI] 1.182–2.925, P = 0.007).

Conclusion

POI is a common complication after hysterectomy. This study identified risk factors of POI specifically for gynecologic patients. Patients exposed to these factors should be monitored closely for the development POI.

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Funding

This research is funded by National Natural Science Foundation of China (grant number 81671955).

Author information

Author notes

  1. Zhen-Lue Li and Bing-Cheng Zhao are co-first authors and contributed equally to this work.

Affiliations

  1. Department of Anesthesiology, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Ave N, Guangzhou, 510515, China

    Zhen-Lue Li, Bing-Cheng Zhao, Wen-Tao Deng, Pei-Pei Zhuang, Wei-Feng Liu, Cai Li & Ke-Xuan Liu

Authors
  1. Zhen-Lue Li
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  2. Bing-Cheng Zhao
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  3. Wen-Tao Deng
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  4. Pei-Pei Zhuang
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  5. Wei-Feng Liu
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  6. Cai Li
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  7. Ke-Xuan Liu
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Contributions

ZL li: protocol development, data collection and management, data analysis, manuscript writing. BC Zhao: protocol development, data analysis, manuscript writing, manuscript editing. WT Deng: protocol development, data collection. PP Zhuang: protocol development, data collection. WF Liu: protocol development, data analysis, manuscript writing. C Li: protocol development, data analysis, manuscript editing. KX Liu: protocol development, data analysis, manuscript editing.

Corresponding authors

Correspondence to Cai Li or Ke-Xuan Liu.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

Our institutions’ ethics board reviewed the study and approved it.

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Informed consent was not required in our institution for retrospective data study.

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Li, ZL., Zhao, BC., Deng, WT. et al. Incidence and risk factors of postoperative ileus after hysterectomy for benign indications. Int J Colorectal Dis 35, 2105–2112 (2020). https://doi.org/10.1007/s00384-020-03698-5

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  • DOI: https://doi.org/10.1007/s00384-020-03698-5

Keywords

  • Hysterectomy
  • Postoperative ileus
  • Risk factors
  • Complications