Postoperative ileus in an enhanced recovery pathway-a retrospective cohort study.

Details

Serval ID
serval:BIB_CC8B3072D19F
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Postoperative ileus in an enhanced recovery pathway-a retrospective cohort study.
Journal
International journal of colorectal disease
Author(s)
Grass F., Slieker J., Jurt J., Kummer A., Solà J., Hahnloser D., Demartines N., Hübner M.
ISSN
1432-1262 (Electronic)
ISSN-L
0179-1958
Publication state
Published
Issued date
05/2017
Peer-reviewed
Oui
Volume
32
Number
5
Pages
675-681
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Enhanced recovery after surgery (ERAS) protocols advocate no nasogastric tubes after colorectal surgery, but postoperative ileus (POI) remains a challenging clinical reality. The aim of this study was to assess incidence and risk factors of POI.
This retrospective analysis included all consecutive colorectal surgical procedures since May 2011 until November 2014. Uni- and multivariate risk factors for POI were identified by multiple logistic regression and functional and surgical outcomes assessed.
The study cohort consisted of 513 consecutive colorectal ERAS patients. One hundred twenty-eight patients (24.7%) needed postoperative reinsertion of nasogastric tube at the 3.9 ± 2.9 postoperative day. Multivariate analysis retained the American Society of Anesthesiologists group 3-4 (odds ratio (OR) 1.3; 95% CI 1-1.8, p = 0.043) and duration of surgery of >3 h (OR 1.3; 95% CI 1-1.7, p = 0.047) as independent risk factors for POI. Minimally invasive surgery (OR 0.6; 95% CI 0.5-0.8, p ≤ 0.001) and overall compliance of >70% to the ERAS protocol (OR 0.7; 95% CI 0.6-1, p = 0.031) represented independent protective factors. POI was associated with respiratory (23 vs. 5%, p ≤ 0.001) and cardiovascular (16 vs. 3%, p ≤ 0.001) complications.
POI was frequent in the present study. Overall compliance to the ERAS protocol and minimally invasive surgery helped to prevent POI, which was significantly correlated with medical complications.

Keywords
Demography, Female, Humans, Ileus/epidemiology, Ileus/etiology, Incidence, Male, Middle Aged, Multivariate Analysis, Postoperative Care, Postoperative Complications/epidemiology, Postoperative Complications/etiology, Retrospective Studies, Risk Factors, Treatment Outcome, Colorectal, Compliance, Enhanced recovery, Fast track, Ileus, Nasogastric drainage
Pubmed
Web of science
Create date
21/03/2017 19:33
Last modification date
20/08/2019 16:47
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