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Multicenter Study
. 2023 Oct;16(4):706-714.
doi: 10.1111/ases.13227. Epub 2023 Jul 6.

Incidence of and risk factors for postoperative ileus between right and left laparoscopic colectomy using propensity-score-matched analysis: A retrospective multicenter study

Fumitake Uchida  1   2 , Tetsuro Tominaga  1 , Takashi Nonaka  1 , Kazuo To  2 , Makoto Hisanaga  3 , Hiroaki Takeshita  4 , Hidetoshi Fukuoka  5 , Kenji Tanaka  6 , Terumitsu Sawai  1 , Takeshi Nagayasu  1
Affiliations
Multicenter Study

Incidence of and risk factors for postoperative ileus between right and left laparoscopic colectomy using propensity-score-matched analysis: A retrospective multicenter study

Fumitake Uchida et al. Asian J Endosc Surg. 2023 Oct.

Abstract

Instruction: In colon cancer, the incidence of postoperative ileus is reportedly higher for the right-side than for the left-side colon, but those studies included small numbers of subjects and contained several biases. Furthermore, risk factors for postoperative ileus remain unclear.

Methods: This multicenter study reviewed 1986 patients who underwent laparoscopic colectomy between 2016 and 2021 for right-side (n = 907) and left-side (n = 1079) colon cancer. After propensity score matching, 803 patients in each group were matched.

Results: Postoperative ileus occurred in 97 patients. Before matching, the proportion of female patients and median age were higher and frequency of preoperative stent insertion was lower with right colectomy (P < .001 each). After matching, the number of retrieved lymph nodes (17 vs 15, P < .001) and greater rates of undifferentiated adenocarcinoma (10.6% vs 5.1%, P < .001) and postoperative ileus (6.4% vs 3.2%, P = .004) were higher in right colectomy. Multivariate analysis revealed male gender (hazard ratio, 1.798; 95% confidence interval, 1.049-3.082; P = .32) and history of abdominal surgery (hazard ratio, 1.909; 95% confidence interval, 1.073-3.395; P = .027) as independent predictors of postoperative ileus in right-side colon cancer.

Conclusion: This study revealed a higher risk of postoperative ileus after right colectomy with laparoscopic surgery. Male gender and history of abdominal surgery were risk factors for postoperative ileus after right colectomy.

Keywords: colon cancer; postoperative ileus; sidedness.

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References

REFERENCES

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