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. 2022 Jul 16:10:100109.
doi: 10.1016/j.sipas.2022.100109. eCollection 2022 Sep.

Preoperative small bowel dilation is associated with ileus after right colectomy

Alexander Booth  1 , Matthew Di Leo  1 , Mark Kovacs  2 , Pinckney Johnstone Maxwell 4th  1 , Colleen Donahue  1 , Virgilio V George  1 , Thomas Curran  1
Affiliations

Preoperative small bowel dilation is associated with ileus after right colectomy

Alexander Booth et al. Surg Pract Sci. .

Abstract

Background: The relationship between preoperative bowel dysfunction and postoperative ileus has not been explored clinically. We hypothesized chronic partial obstruction, based on preoperative small bowel diameter, is associated with ileus after colon surgery.

Methods: This was a retrospective case-control study of patients undergoing right colectomy or ileocolic resection with primary anastomosis. Patients who developed ileus were compared to those who did not.

Results: Postoperative ileus occurred in 22 of 69 patients (32%). Preoperative small bowel dilation with maximum diameter >3 cm was present in 13 patients (19%) with 7 developing ileus (54%; p=0.06). In a multivariable model, small bowel dilation >3 cm (OR 4.6; 95% CI: 1.3-16.6) and preoperative weight loss >10 pounds (OR 9.8; 95% CI: 1.6-57.9) were independently associated with ileus.

Conclusions: Colorectal surgery patients with preoperative bowel dilation have an increased risk of postoperative ileus. This knowledge can better inform patient expectations for recovery and help guide perioperative nutritional management, particularly with patient selection for parenteral nutrition.

Keywords: Colorectal surgery; Enhanced recovery; Ileus; Perioperative management; Perioperative nutrition.

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Conflict of interest statement

Thomas Curran reports a relationship with Intuitive Surgical Inc that includes: travel reimbursement. Thomas Curran reports a relationship with Applied Medical that includes: travel reimbursement.

Figures

Fig1
Fig.1
Proportion of patients with ileus by presence of preoperative risk factor Shaded bars represent the proportion of patients who developed ileus with small bowel dilation over 3 cm, greater than 10% body weight loss within 6 months, or neither risk factor.
See this image and copyright information in PMC

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