Humans ; Intestinal Obstruction/complications* ; Ileus/etiology* ; Abdominal Injuries/complications*

OBJECTIVETo compare the incidence of postoperative ileus following laparoscopic and open radical resection for colorectal cancer using meta-analysis.

METHODSThe Cochrane library, Pubmed, Ovid databases were searched as of October 2011. Two reviewers extracted the data and assessed the methodological quality independently. The homogeneity of studies was evaluated and the meta-analysis was conducted by the Cochrane Collaboration RevMan 5.0 software.

RESULTSSeven studies including 3630 cases were analyzed. A total of 1814 patients received laparoscopic surgery, of whom 58 developed postoperative ileus. There were 1816 cases undergoing open surgery, of whom 105 developed early postoperative ileus. The pooled relative risk was 0.55 with a 95% confidence interval of 0.41-0.76. The difference was statistically significant(P<0.01).

CONCLUSIONCompared with open surgery, laparoscopic colorectal resection can reduce the incidence of postoperative ileus.

Colectomy ; Colorectal Neoplasms ; surgery ; Humans ; Ileus ; epidemiology ; etiology ; Incidence ; Laparoscopy ; Postoperative Complications

Acupuncture Points ; Acupuncture Therapy ; Adult ; Female ; Humans ; Ileus ; complications ; Intestinal Diseases ; etiology ; pathology ; therapy ; Tissue Adhesions ; pathology ; therapy

The present case is one of gallstone obstructive ileus due to gallstones 3 yr after laparoscopic cholecystectomy. It is interesting because of the sex of the patient, the fact that ileus occurred 3 yr after cholecystectomy and that the localization of the obstruction was an old side-to-side ileoileal anastomosis due to a diverticulectomy following intussusception of Meckels' diverticulum at the age of 3.
Adult ; Anastomosis, Surgical/*adverse effects ; Child, Preschool ; Cholecystectomy, Laparoscopic/*adverse effects ; Gallstones/*complications ; Humans ; Ileum/pathology/*surgery ; Ileus/*etiology ; Intestinal Obstruction/*etiology ; Male ; Meckel Diverticulum/surgery

OBJECTIVETo investigate the associated factors for postoperative ileus following radical resection for colorectal cancer.

METHODSClinical data of 1366 colorectal cancer patients undergoing radical resection by the same surgical team in our hospital from January 2000 to September 2011 were analyzed retrospectively. Univariate analysis and multivariate logistic regression analysis were used to identify the associated factors of postoperative ileus.

RESULTSA total of 70 patients(5.1%) developed postoperative ileus. Univariate and multivariate analyses showed that N2(OR=1.893, 95%CI:1.083-3.306), history of colorectal cancer resection(OR=4.899, 95%CI:1.490-16.110), preoperative obstruction (OR=2.616, 95%CI:1.297-5.280), right hemicolectomy(OR=2.024, 95%CI:1.052-3.894) and left hemicolectomy(OR=3.030, 95%CI:1.401-6.550) were risk factors for postoperative ileus following radical resection for colorectal cancer, while laparoscopic operation(OR=0.520, 95%CI:0.319-0.849) was protective.

CONCLUSIONSPostoperative ileus following radical resection for colorectal cancer is associated with surgical procedures. Laparoscopic colorectal resection can reduce the incidence of postoperative ileus.

Colectomy ; adverse effects ; Colorectal Neoplasms ; surgery ; Factor Analysis, Statistical ; Humans ; Ileus ; etiology ; surgery ; Incidence ; Laparoscopy ; Multivariate Analysis ; Postoperative Complications ; Retrospective Studies ; Risk Factors

Bezoars ; complications ; Fruit ; adverse effects ; Gallstones ; diagnosis ; pathology ; Humans ; Ileus ; diagnosis ; etiology ; Male ; Middle Aged ; Seeds ; adverse effects ; Tomography, X-Ray Computed

OBJECTIVETo investigate the risk factors of prolonged postoperative ileus (PPOI) after gastric cancer surgery.

METHODSDefinition of PPOI was that gastrointestinal function did not return to normal within 96 hours after operation. Diagnostic criteria of PPOI were as follows: according with over 2 below conditions at postoperative 97-hour: (1) moderate to severe sick (mild: 1-3 points, moderate: 4-7 points, severe: 8-10 points) or vomiting occurred in past 12 hours. (2) patient was intolerable of solid food in the last 2 meals and reported the food-intake as less than 25%. (3) no flatus and defecation occurred in past 24 hours. (4) moderate to severe abdominal distension was diagnosed by doctor with knocking abdomen. (5) iconography examination (abdominal X-ray or CT) in past 24 hours revealed gastrectasis, gas-fluid plane, intestinal or colorectal loop extension, indicating the ileus. A total of 83 patients with gastric carcinoma confirmed by preoperative gastroscopic pathology undergoing operation at the Department of General Surgery, Chinese PLA General Hospital from August 2016 to October 2016 were prospectively enrolled in the study. The incidence and risk factors of PPOI after gastric cancer surgery were calculated and analyzed with univariate and logistic regression multivariate analyses.

RESULTSOf 83 gastric cancer patients, 62 were male and 21 were female with an average age of (60.1±11.0)(39-89) years. Postoperative pathology showed 41 cases with III(-IIII( stage, 42 cases with I(-II( stage. According to the above diaguostic criteria, 22(26.5%) patients were diagnosed as PPOI postoperatively. Among 22 cases, 3 cases had no flatus and defecation with moderate-severe sick and vomiting within postoperative 96 hours; 15 cases had no flatus and defecation with moderate-severe abdominal extension within postoperative 96 hours; 4 cases had no flatus and defecation with moderate-severe sick, vomiting and moderate-severe abdominal extension within postoperative 96 hours. Clinical symptoms of all the POOI patients were improved following conservative treatment. Univariate analysis showed that age ≥65 years[13/26(50.0%) vs. 9/57(15.8%), χ=10.727, P=0.001], postoperative body temperature ≥38.0centi-degree [8/17(47.1%) vs. 14/66(21.2%), χ=4.636, P=0.031], postoperative serum potassium level[20/81(24.7%) vs. 2/2, χ=5.682, P=0.017], and use of opioid agent Dezocine [15/38(39.5%) vs. 7/45(15.6%), χ=6.050, P=0.014] were associated with POOI. Logistic regression analysis showed that age ≥65 years (OR=17.415, 95%CI:17.151-17.750, P=0.015), postoperative body temperature ≥38centi-degree(OR=15.855, 95%CI:15.422-16.214, P=0.013), use of Dezocine after surgery (OR=21.379, 95%CI:20.814-21.654, P=0.010) were the independent risk factors of PPOI after gastric cancer surgery.

CONCLUSIONGastric patients with older age, increased body temperature and the use of Dezocine after surgery have higher risk of POOI and need special perioperative management and treatment.

Adult ; Aged ; Aged, 80 and over ; Digestive System Surgical Procedures ; Female ; Humans ; Ileus ; etiology ; Male ; Middle Aged ; Postoperative Complications ; Risk Factors ; Stomach Neoplasms ; surgery