Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2011 Dec;27(6):315-21.
doi: 10.3393/jksc.2011.27.6.315. Epub 2011 Dec 31.

Risk factors of early postoperative small bowel obstruction following a proctectomy for rectal cancer

Jin Yong Shin  1
Affiliations

Risk factors of early postoperative small bowel obstruction following a proctectomy for rectal cancer

Jin Yong Shin. J Korean Soc Coloproctol. 2011 Dec.

Abstract

Purpose: Postoperative small bowel obstruction is a common and serious complication following a proctectomy, and early postoperative small bowel obstruction (EPSBO) leads to longer hospital stays, delays chemotherapy in advanced cases, and may be a contributor to mortality. The goal of this study is to identify the risk factors of EPSBO after a proctectomy for rectal cancer, thereby seeking to reduce the incidence of EPSBO.

Methods: Patients (735) who underwent a proctectomy for rectal cancer between March 2005 and February 2010 were entered into this study, and data were collected prospectively. Patients were judged to have EPSBO if, within the first 30 days, they presented symptoms such as nausea, vomiting and abdominal distention lasting for 2 days, and radiologic finding of small bowel obstruction after evidence of return of small bowel motility. The association between EPSBO and patients and surgery-related variables were studied by using univariate and multivariate analyses.

Results: EPSBO developed in 47 cases (6.4%) and was the most frequently occurring complication in the early perioperative period following a proctectomy. The frequency of EPSBO according to operative variables shows that EPSBO developed in 3.0% of the patients who underwent laparoscopic surgery (LS) compared with 8.4% of the patients who underwent open surgery (OS) (P = 0.004). OS (odds ratio [OR], 2.5) and a previous laparotomy (OR, 2.3) were independent risk factors for the development of EPSBO after a proctectomy for rectal cancer.

Conclusion: EPSBO is more likely to occur in patients who undergo OS or who have had a previous laparotomy. LS may be considered as a surgical procedure that can reduce the risk of EPSBO in patients undergoing a proctectomy for rectal cancer.

Keywords: Laparoscopy; Rectal neoplasms; Small bowel obstruction.

PubMed Disclaimer

Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Similar articles

See all similar articles

Cited by

References

    1. Ju JH, Chang SC, Wang HS, Yang SH, Jiang JK, Chen WC, et al. Changes in disease pattern and treatment outcome of colorectal cancer: a review of 5,474 cases in 20 years. Int J Colorectal Dis. 2007;22:855–862. - PubMed
    1. Iversen LH, Norgaard M, Jepsen P, Jacobsen J, Christensen MM, Gandrup P, et al. Trends in colorectal cancer survival in northern Denmark: 1985-2004. Colorectal Dis. 2007;9:210–217. - PubMed
    1. Birgisson H, Talback M, Gunnarsson U, Pahlman L, Glimelius B. Improved survival in cancer of the colon and rectum in Sweden. Eur J Surg Oncol. 2005;31:845–853. - PubMed
    1. Paun BC, Cassie S, MacLean AR, Dixon E, Buie WD. Postoperative complications following surgery for rectal cancer. Ann Surg. 2010;251:807–818. - PubMed
    1. Marusch F, Koch A, Schmidt U, Wenisch H, Ernst M, Manger T, et al. Early postoperative results of surgery for rectal carcinoma as a function of the distance of the tumor from the anal verge: results of a multicenter prospective evaluation. Langenbecks Arch Surg. 2002;387:94–100. - PubMed

LinkOut - more resources