Postoperative Mechanical Ileus Requiring Surgery in Patients with Colorectal Cancer.
- Author:
Won Yong CHOI
1
;
Dong Hee LEE
;
Choon Sik JEONG
;
Chang Nam KIM
;
Hee Cheol KIM
;
Chang Sik YU
;
Jin Cheon KIM
Author Information
1. Department of Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Colorectal cancer;
Mechanical ileus
- MeSH:
Colorectal Neoplasms*;
Hernia;
Humans;
Ileus*;
Incidence;
Mortality;
Postoperative Period;
Rectal Neoplasms;
Recurrence;
Risk Factors
- From:Journal of the Korean Surgical Society
1999;56(2):241-247
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Postoperative ileus is not an infrequent problem in clinical practice and is the major cause of morbidity with occasional mortality. The purposes of this study were to analyze clinical features and to assess associated risk factors in postoperative mechanical ileus. METHODS: We reviewed the cases of 43 patients with mechanical ileus who had undergone exploration from among the 1631 colorectal cancer patients treated between June 1989 and December 1997. RESULTS: The causes of postoperative ileus were postoperative adhesion, recurrence of cancer, and hernia, and these causes were closely associated with postoperative periods (period I, <4 months; period II, 4-12 months; period III, >12 months). Adhesion was the most common cause of obstruction in the early postoperative period (period I, 86%), while cancer recurrence increased with time (period I: 7%, period II: 36%, period III: 53%). The clinical features of simple and strangulated obstructions were not significantly different. We could find no significant correlation between clinicopathological findings of the tumor and postoperative ileus requiring surgery. Among 874 rectal cancer patients, 122 patients (15.1%) received adjuvant radiation therapy (RT) postoperatively. The cases receiving RT presented a significant increase in the incidence of postoperative ileus and surgical treatment (28% vs 7.5%, 15% vs 1%, respectively, p<0.001). CONCLUSIONS: major cause of postoperative mechanical ileus requiring surgery in colorectal cancer patients was adhesion until one year postoperatively and cancer recurrence thenafter. Postoperative RT seems to be a risk factor of postoperative mechanical ileus.
