Risk factors for postoperative ileus after colorectal cancer surgery

AimThe aim was to assess the rate and independent risk factors of postoperative ileus after colorectal cancer surgery. MethodsThree hundred consecutive patients underwent colorectal surgery for cancer at the State Scientific Centre of Coloproctology, Moscow, Russia, between November 2015 and August 2016. Postoperative ileus was diagnosed as an absence of intestinal function for 72h or more after operation and was confirmed by plain radiography. Univariate and multivariate logistic regression of the tumour-, patient- and treatment-related factors was performed. All patients had epidural catheters with multimodal analgesia. ResultsThirty-nine patients (13%) had postoperative ileus. The variables associated with this condition in univariate analysis were age <64years (P=0.02), male gender (P=0.02), body mass index25kg/m(2) (P=0.02), moderate drinking (P=0.02), heavier drinking (P<0.0001), opioids (P=0.02), history of abdominal operation (P=0.003), firm extensive adhesions as a result of previous surgery (P=0.005), multivisceral resection (P=0.009), blood loss150ml (P=0.006), haemotransfusion (P=0.01) and open approach (P=0.006). In the multivariate logistic regression, body mass index26kg/m(2) (P=0.008), opioids (P=0.04), history of abdominal operation (P= 0.04) and adhesions (P=0.03) were identified as independent risk factors. ConclusionPostoperative ileus is a common complication in colorectal surgery. The results of our study suggest at least two surgeon-dependent risk factors, i.e. open approach and opioids in the postoperative period.