Delayed return of bowel function after general surgery in South Australia

Joshua G Kovoor^{1

2

3

4}, Stephen Bacchi^{3

5

6

7}, Brandon Stretton^{1

3

6}, Aashray K Gupta^{1

3

8}, Jonathan Henry W Jacobsen^{2

9}, Minh-Son To^{3

5

6

10}, Rudy Goh^{3

6

11}, Joseph N Hewitt^{1

3

12}, Christopher D Ovenden^{3

6

11}, Leigh Warren^{1

3

11}, Matthew Marshall-Webb^{1

3

13}, Karen L Jones^{6

11}, Benjamin A Reddi^{6

11}, Danny Liew^{6

11}, Christopher Dobbins^{6

11}, Robert T Padbury⁵, Peter J Hewett¹, Thomas J Hugh^{14

15}, Markus I Trochsler¹, Guy J Maddern^{1

2}

Affiliations

¹ Discipline of Surgery, The University of Adelaide, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia.
² Royal Australasian College of Surgeons, Adelaide, South Australia, Australia.
³ Health and Information, Adelaide, South Australia, Australia.
⁴ Ballarat Base Hospital, Ballarat, Victoria, Australia.
⁵ Flinders University, Adelaide, South Australia, Australia.
⁶ Royal Adelaide Hospital, Adelaide, South Australia, Australia.
⁷ Lyell McEwin Hospital, Adelaide, South Australia, Australia.
⁸ Prince of Wales Hospital, Sydney, New South Wales, Australia.
⁹ University of Melbourne, Melbourne, Victoria, Australia.
¹⁰ Flinders Medical Centre, Adelaide, South Australia, Australia.
¹¹ University of Adelaide, Adelaide, South Australia, Australia.
¹² Wagga Wagga Base Hospital, Wagga Wagga, New South Wales, Australia.
¹³ Box Hill Hospital, Melbourne, Victoria, Australia.
¹⁴ University of Sydney, Sydney, New South Wales, Australia.
¹⁵ Royal North Shore Hospital, Sydney, New South Wales, Australia.

PMID: 39845344
PMCID: PMC11749973
DOI: 10.1016/j.sipas.2024.100234

Delayed return of bowel function after general surgery in South Australia

Joshua G Kovoor et al. Surg Pract Sci. 2024.

. 2024 Jan 10:16:100234.

doi: 10.1016/j.sipas.2024.100234. eCollection 2024 Mar.

Authors

Affiliations

¹ Discipline of Surgery, The University of Adelaide, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia.
² Royal Australasian College of Surgeons, Adelaide, South Australia, Australia.
³ Health and Information, Adelaide, South Australia, Australia.
⁴ Ballarat Base Hospital, Ballarat, Victoria, Australia.
⁵ Flinders University, Adelaide, South Australia, Australia.
⁶ Royal Adelaide Hospital, Adelaide, South Australia, Australia.
⁷ Lyell McEwin Hospital, Adelaide, South Australia, Australia.
⁸ Prince of Wales Hospital, Sydney, New South Wales, Australia.
⁹ University of Melbourne, Melbourne, Victoria, Australia.
¹⁰ Flinders Medical Centre, Adelaide, South Australia, Australia.
¹¹ University of Adelaide, Adelaide, South Australia, Australia.
¹² Wagga Wagga Base Hospital, Wagga Wagga, New South Wales, Australia.
¹³ Box Hill Hospital, Melbourne, Victoria, Australia.
¹⁴ University of Sydney, Sydney, New South Wales, Australia.
¹⁵ Royal North Shore Hospital, Sydney, New South Wales, Australia.

PMID: 39845344
PMCID: PMC11749973
DOI: 10.1016/j.sipas.2024.100234

Abstract

Introduction: Reference ranges for determining pathological versus normal postoperative return of bowel function are not well characterised for general surgery patients. This study aimed to characterise time to first postoperative passage of stool after general surgery; determine associations between clinical factors and delayed time to first postoperative stool; and evaluate the association between delay to first postoperative stool and prolonged length of hospital stay.

Methods: This study included consecutive admissions at two tertiary hospitals across a two-year period whom underwent a range of general surgery operations. Multivariable logistic regression analyses were conducted to determine associations between the explanatory variables and delayed first postoperative stool, and between delayed first postoperative stool and length of hospital stay. The previously specified explanatory variables were used, with the addition of the dichotomised ≥4-day delay to first postoperative stool. Prolonged length of hospital stay was considered ≥7 days.

Results: 2,212 general surgery patients were included. Median time to first postoperative stool was 2.28 (IQR 1.06-3.96). Median length of stay was 7.19 (IQR 4.50-12.01). Several operative characteristics and medication exposures were associated with delayed first postoperative stool. There was a statistically significant association between delayed first postoperative stool (≥4 days) and prolonged length of stay (≥7 days) (OR 4.34, 95 %CI 3.27 to 5.77, p < 0.001).

Conclusions: This study characterised expected reference ranges for time to return of bowel function across various general surgery operations and determined associations with clinical factors that may improve efficiency and identification of pathology within the postoperative course.

Keywords: Bowel function; General surgery; Outcomes; Postoperative recovery; care; stool.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig 1 — **Fig. 1**
Histogram of time to first postoperative stool in general surgery inpatients (outliers beyond 10 days omitted).

See this image and copyright information in PMC

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Delayed return of bowel function after general surgery in South Australia

Affiliations

Delayed return of bowel function after general surgery in South Australia

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

LinkOut - more resources

Full Text Sources