Background Prolonged postoperative ileus (PPOI) is a common complication in colorectal surgeries. However, the risk factors for PPOI after anterior resection of rectum in patients with rectal cancer has not been well studied.
Objective To investigate the risk factors of prolonged postoperative ileus (PPOI) after anterior resection of rectum (AR) in patients with rectal cancer, and establish a risk prediction model.
Methods A retrospective analysis was performed in 130 patients who underwent radical anterior resection treatment of rectal cancer from August 2016 to August 2018, in the Department of General Surgery of Chinese PLA General Hospital. The occurrence of PPOI was counted, and the risk factors of PPOI were obtained by multivariate logistic regression analysis. The risk prediction model of nomogram was constructed and the effectiveness was verified.
Results Of the 130 patients included in the study, 30 (23.1%) cases were diagnosed with PPOI. Univariate analysis showed that patients with hypertension, diabetes, intraoperative hemorrhage greater than 200 mL and postoperative gastric tube indwelling time more than 48 hours had significant higher incidence of PPOI. Multivariate analysis results showed that hypertension (OR: 3.012, 95% CI: 1.139 - 7.966), intraoperative hemorrhage more than 200 mL (OR: 5.318, 95% CI: 1.712 -16.521) and postoperative gastric tube indwelling time more than 48 hours (OR: 5.379, 95% CI: 1.614 - 17.925) were the risk factors of PPOI. Based on the results of multivariate analysis, the PPOI occurrence risk prediction nomogram was constructed, and the internal verification consistency index (C-index) was 0.760 (95% CI: 0.670 - 0.849).
Conclusion Hypertension, intraoperative hemorrhage more than 200 mL and postoperative gastric tube indwelling time more than 48 hours are risk factors for PPOI in patients with rectal cancer after anterior rectal resection. The PPOI occurrence risk prediction nomogram has good performance in evaluation, and is worthy of generalizing.
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