A Study of risk factors of postoperative ileus after laparoscopic colorectal resection.

Aim: Postoperative ileus (POI) is a common complication after abdominal surgery. However, the risk factors for POI after laparoscopic colorectal resection are unclear. We therefore investigated the risk factors for POI after laparoscopic colorectal surgery.

Methods: This retrospective study involved 484 patients who underwent laparoscopic surgery for primary colorectal cancer at Hokkaido University Hospital. We categorized the patients into a POI group ( = 19) and non-POI group ( = 465). We compared sex, age, smoking, chronic obstructive pulmonary disease (COPD), diabetes mellitus, body mass index (BMI), cardiac disorder, serum albumin, American Society of Anesthesiologists-physical status, tumor location, tumor stage, operative duration, stoma formation, lymph node dissection, operator, and bleeding as potential risk factors for POI between the POI group and non-POI group by univariate and multivariate analyses.

Results: The univariate analysis results showed that the POI group had a higher incidence of male sex ( 0.036), COPD ( 0.029), and a BMI of <20 kg/m ( 0.0487) as well as a higher bleeding volume ( 0.014). The multivariate analysis results showed that male sex (odds ratio [OR], 0.2799; 95% confidence interval [CI], 0.089-0.993;  0.0298), COPD (0.2866; 0.095-0.862;  0.0262), and a BMI of <20 kg/m (0.2985; 0.112-0.794;  0.0154) were independent risk factors for POI after laparoscopic colorectal resection.

Conclusion: Our findings suggest that male sex, COPD, and a BMI of <20 kg/m are independent risk factors for POI after laparoscopic colorectal surgery for treatment of colorectal cancer.