AI Article Synopsis

  • This study investigates postoperative ileus (POI) as a complication following spine surgery, specifically thoracolumbar and lumbar fusion surgeries, by reviewing existing literature and evaluating risk factors.
  • The research analyzed data from 10 articles involving 297,809 patients and found significant associations between POI and factors such as older age, longer surgical and anesthesia times, greater estimated blood loss, and longer hospital stays.
  • Additionally, male patients, those undergoing an anterior surgical approach, and patients with more than three vertebral levels fused were found to have higher odds of developing POI, while body mass index did not show a significant link.

Article Abstract

Objective: Postoperative ileus (POI) is a known complication after spine surgery. This study comprehensively reviews the existing literature and evaluates the risk factors associated with POI after thoracolumbar and lumbar fusion surgeries.

Methods: In accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, a comprehensive search was conducted for articles on ileus after the surgical treatment of spinal pathologies. Variables including gender, age, body mass index, comorbidities, approach, type of surgery performed, levels fused, anesthesia time, and length of stay were considered as the main outcomes of measurement. Meta-analyses were conducted using random models according to the between-study heterogeneity, estimated with I. Sensitivity analysis was performed with heterogeneity greater than 50%.

Results: Ten articles compromising a total of 297,809 patients met the inclusion criteria. POI after lumbar surgery had a statistically significant association with increased age, surgical time, anesthesia time, estimated blood loss, and length of stay. The pooled mean differences were 1.70 years (95% confidence interval [CI]: 1.52-1.87, P < 0.0001), 83.02 minutes (CI: 41.20-124.84, P = 0.0001), 64.97 minutes (CI: 31.43-98.50, P = 0.0001), 439.04 cc (CI: 250.60-627.49, P < 0.001), and 2.97 days (CI: 2.54-3.40, P < 0.001), respectively. Furthermore, individuals who underwent spinal fusion had higher odds of POI if they were male (odds ratio [OR]: 1.33; CI: 1.06-1.67; P = 0.01), if an anterior approach was performed (OR: 1.97; CI: 1.29-3.01; P = 0.002), or if >3 vertebral levels were fused (OR: 3.99; CI: 1.28-12.44; P = 0.02). Body mass index did not show any association with POI.

Conclusions: Risk factors associated with POI after spinal fusion surgery include male gender, older age, longer surgical times, higher estimated blood loss, longer lengths of stay, greater numbers of levels of fusion, and anterior surgical approach.

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Source
http://dx.doi.org/10.1016/j.wneu.2022.10.025DOI Listing

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