Incidence and risk factors of postoperative ileus after hysterectomy for benign indications
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ORIGINAL ARTICLE
Incidence and risk factors of postoperative ileus after hysterectomy for benign indications Zhen-Lue Li 1 & Bing-Cheng Zhao 1 & Wen-Tao Deng 1 & Pei-Pei Zhuang 1 & Wei-Feng Liu 1
&
Cai Li 1 & Ke-Xuan Liu 1
Accepted: 14 July 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose Postoperative ileus (POI) after abdominal surgery is associated with prolonged hospital stay and increased costs. The aim of this study is to investigate the incidence of, risk factors for, and outcomes associated with POI in patients undergoing hysterectomy for benign indications. Methods A retrospective review of 1017 consecutive patients undergoing benign hysterectomy over the period 2012–2017 in a single center was performed. POI was predefined as absence of flatus and defecation for more than 2 days with the presence of one or more of the following symptoms: nausea, vomiting, and abdominal distention. The association between perioperative variables and the risk of POI was evaluated by univariate analysis. Independent risk factors were identified by multivariate logistic regression analysis. Results Overall incidence of POI was 9.2%. Incidence of POI did not differ significantly among three different surgical approaches (abdominal hysterectomy, 10.6%; laparoscopic hysterectomy, 7.8%; vaginal hysterectomy, 11.3%; P = 0.279). Independent risk factors of POI identified by multivariate analysis included anesthesia technique (odds ratio [OR] 2.662, 95% interval [CI] 1.533–4.622, P = 0.001), adhesiolysis (odds ratio [OR] 1.818, 95% interval [CI] 1.533–4.622, P = 0.011), duration of operation (odds ratio [OR] 1.005, 95% interval [CI] 0.942–6.190, P = 0.029), previous cancer (odds ratio [OR] 4.789, 95% interval [CI] 1.232–18.626, P = 0.024), and dysmenorrhea (odds ratio [OR] 1.859, 95% interval [CI] 1.182–2.925, P = 0.007). Conclusion POI is a common complication after hysterectomy. This study identified risk factors of POI specifically for gynecologic patients. Patients exposed to these factors should be monitored closely for the development POI. Keywords Hysterectomy . Postoperative ileus . Risk factors . Complications
Introduction The transient inhibition of gastrointestinal (GI) motility after surgery is referred as postoperative ileus (POI). Factors associated with surgery and anesthesia have pathophysiologic impact upon GI organs, clinically manifested as nausea, vomiting, abdominal distension, intolerance of oral intake, and lack of flatus and defecation. This phenomenon induced Zhen-Lue Li and Bing-Cheng Zhao are co-first authors and contributed equally to this work. * Cai Li [email protected] * Ke-Xuan Liu [email protected] 1
Department of Anesthesiology, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Ave N, Guangzhou 510515, China
by surgical stress is most commonly seen in abdominal surgery, especially those involving direct manipulation of the guts, but could also occur in other surgery types. Literature regarding this topic in patients who underwent benign hyster
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