Impact of prior abdominal surgery on postoperative prolonged ileus after ileostomy repair

Abstract

Background and aims: Postoperative ileus (POI) is one of the most common reasons for sustained hospital stays after ileostomy repair. Although many factors have been investigated as POI risk factors, the investigation of the impact of prior abdominal surgery (PAS) before rectal cancer surgery has been limited. This study aimed to identify the impact of PAS as a risk factor for POI after ileostomy repair. Material and methods: A total of 220 consecutive patients with rectal cancer who underwent ileostomy repair were enrolled. The patients were divided into PAS-positive and PAS-negative groups according to the history of PAS before rectal cancer surgery. Univariate and multivariate analyses were performed to identify the clinicopathological factors associated with POI. Results: The PAS-positive group had a longer operation time (111 min vs. 93.4 min, p=0.029) and a greater length of hospital stay (10 days vs. 7.8 days, p=0.003) compared with the PAS-negative group. POI was more frequent in the PAS-positive group (23.1% vs. 6.2%, p=0.011). The POI rate in the entire cohort was 8.1%. The repair method (stapled side-to-side vs. hand-sewn end-to-end, odds ratio OR=3.6, 95% confidence interval CI=1.2–11.1, p=0.022) and PAS (odds ratio=4.0, 95% confidence interval=1.2–12.8, p=0.017) were significant predictors of POI in the multivariate analysis. Conclusions: This study suggests that PAS before rectal cancer surgery is associated with POI after ileostomy repair.

Keywords

• ileostomy repair
• postoperative ileus
• prior abdominal surgery
• rectal cancer