BACKGROUND: Prolonged postoperative ileus (PPOI) represents a frequent complication following colorectal surgery, affecting approximately 10-15% of these patients. The objective of this study was to evaluate the perioperative risk factors for PPOI development in colorectal surgery. METHODS: The present systematic review and meta-analysis was conducted in accordance with the PRISMA Statement. PubMed, EMBASE, SciELO, and LILACS databases were searched, without language or time restrictions, from inception until December 2018. The keywords used were: Ileus, colon, colorectal, sigmoid, rectal, postoperative, postoperatory, surgery, risk, factors. The Newcastle-Ottawa scale and the Jadad scale were used for bias assessment, while the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used for quality assessment of evidence on outcome levels. RESULTS: Of the 64 studies included, 42 were evaluated in the meta-analysis, comprising 29,736 patients (51.84% males; mean age 62 years), of whom 2844 (9.56%) developed PPOI. Significant risk factors for PPOI development were: male sex (OR 1.43; 95% CI 1.25-1.63), age (MD 3.17; 95% CI 1.63-4.71), cardiac comorbidities (OR 1.54; 95% CI 1.19-2.00), previous abdominal surgery (OR 1.44; 95% CI 1.19, 1.75), laparotomy (OR 2.47; 95% CI 1.77-3.44), and ostomy creation (OR 1.44; 95% CI 1.04-1.98). Included studies evidenced a moderate heterogeneity. The quality of evidence was regarded as very low-moderate according to the GRADE approach. CONCLUSIONS: Multiple factors, including demographic characteristics, past medical history, and surgical approach, may increase the risk of developing PPOI in colorectal surgery patients. The awareness of these will allow a more accurate assessment of PPOI risk in order to take measures to decrease its impact on this population.
BACKGROUND: Prolonged postoperative ileus (PPOI) represents a frequent complication following colorectal surgery, affecting approximately 10-15% of these patients. The objective of this study was to evaluate the perioperative risk factors for PPOI development in colorectal surgery. METHODS: The present systematic review and meta-analysis was conducted in accordance with the PRISMA Statement. PubMed, EMBASE, SciELO, and LILACS databases were searched, without language or time restrictions, from inception until December 2018. The keywords used were: Ileus, colon, colorectal, sigmoid, rectal, postoperative, postoperatory, surgery, risk, factors. The Newcastle-Ottawa scale and the Jadad scale were used for bias assessment, while the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used for quality assessment of evidence on outcome levels. RESULTS: Of the 64 studies included, 42 were evaluated in the meta-analysis, comprising 29,736 patients (51.84% males; mean age 62 years), of whom 2844 (9.56%) developed PPOI. Significant risk factors for PPOI development were: male sex (OR 1.43; 95% CI 1.25-1.63), age (MD 3.17; 95% CI 1.63-4.71), cardiac comorbidities (OR 1.54; 95% CI 1.19-2.00), previous abdominal surgery (OR 1.44; 95% CI 1.19, 1.75), laparotomy (OR 2.47; 95% CI 1.77-3.44), and ostomy creation (OR 1.44; 95% CI 1.04-1.98). Included studies evidenced a moderate heterogeneity. The quality of evidence was regarded as very low-moderate according to the GRADE approach. CONCLUSIONS: Multiple factors, including demographic characteristics, past medical history, and surgical approach, may increase the risk of developing PPOI in colorectal surgery patients. The awareness of these will allow a more accurate assessment of PPOI risk in order to take measures to decrease its impact on this population.
Authors: Marco Milone; Ugo Elmore; Enrico Di Salvo; Paolo Delrio; Luigi Bucci; Giuseppe Paolo Ferulano; Carmine Napolitano; Maria Rachele Angiolini; Umberto Bracale; Marco Clemente; Michele D'ambra; Gaetano Luglio; Mario Musella; Ugo Pace; Riccardo Rosati; Francesco Milone Journal: Surg Endosc Date: 2014-11-21 Impact factor: 4.584
Authors: Albert M Wolthuis; Gabriele Bislenghi; Maarten Lambrecht; Steffen Fieuws; Anthony de Buck van Overstraeten; Guy Boeckxstaens; André D'Hoore Journal: Int J Colorectal Dis Date: 2017-04-25 Impact factor: 2.571
Authors: Sjoerd H W van Bree; Sjoerd van Bree; Malaika S Vlug; Malaika Vlug; Willem A Bemelman; Willem Bemelman; Markus W Hollmann; Markus Hollmann; Dirk T Ubbink; Dirk Ubbink; Aeilko H Zwinderman; Koos Zwinderman; Wouter J de Jonge; Wouter de Jonge; Susanne A Snoek; Susanne Snoek; Karen Bolhuis; Esmerij P M van der Zanden; Esmerij van der Zanden; Frans O The; Frans The; Roel J Bennink; Roel Bennink; Guy E E Boeckxstaens; Guy Boeckxstaens Journal: Gastroenterology Date: 2011-05-26 Impact factor: 22.682
Authors: Stephen J Chapman; Joesph J Garner; Thomas M Drake; Mohammed Aldaffaa; David G Jayne Journal: Dis Colon Rectum Date: 2019-02 Impact factor: 4.585
Authors: Anwar Medellin Abueta; Nairo Javier Senejoa; Mauricio Pedraza Ciro; Lina Fory; Carlos Perez Rivera; Carlos Edmundo Martinez Jaramillo; Lina Maria Mateus Barbosa; Heinz Orlando Ibañez Varela; Javier A Carrera; Rafael Garcia Duperly; Luis A Sanchez; Ivan David Lozada-Martinez; Luis Felipe Cabrera-Vargas; Andres Mendoza; Paulo Cabrera; Sebastian Sanchez Ussa; Cristian Paez; Steven D Wexner; Victor Strassmann; Giovanna DaSilva; Salomone Di Saverio; Arianna Birindelli; Roberto Jose Rodríguez Florez; Abraham Kestenberg; Alexander Obando Rodallega; Juan Carlos Sánchez Robles; Carlos Adrian Niño Carrasco; Alessio Impagnatiello; Diletta Cassini; Gianandrea Baldazzi; Francesco Roscio; Gianluca Liotta; Pierluigi Marini; Daniel Gomez; Carlos Edgar Figueroa Avendaño; Daniela Moreno Villamizar; Laura Cabrera; Juan Carlos Reyes; Alexis Narvaez-Rojas Journal: Health Sci Rep Date: 2022-09-01