TTP1.13 Postoperative ileus (POI) in malignant colorectal resections: A cohort study

Aims Post-operative-lleus (POI) occurs in < 30 % of colorectal-cancer (CRC)-resections, associated with increased hospitalization, morbidity & healthcare-costs. Aim of study is to evaluate effects of POI in CRC-resections at a single centre. Methods Cohort study was carried out from Jan'2007 to Jan'2025. Descriptive demography & post-operative outcomes were assessed for POI-patients, non-ileus CRC-resections were recruited as controls. Results POI(n=291) Non-ileus(n=1571) Mann-Whitney-U(p-value) Age(yrs) 72.0±0.7 70.0±0.3 NS Sex(M:F) 203:88 825:746 <0.0001 ASA 2 2 NS BMI(kg/m2) 26.9±0.3 26.5±0.2 NS Emergency(n) 65 326 NS Laparoscopic(n) 157 934 NS Leaks(n) 16 57 NS HAP(n) 68 127 <0.0001 Wound infections(n) 41 120 NS Collection(n) 30 81 NS Sepsis(n) 41 63 < 0.01 Op-time(mins) 189.8±5.0 174.3±2.2 0.0017 LOS(days) 14 ± 6 7 ± 3.5 <0.0001 POI-onset(days) 5 ± 2 NG tube(days) 3 ± 1 TPN(n) 34 4 Day5-WCC 8.5±0.3 8.7±0.2 NS Day5-CRP 148.1±6.7 119.8±3.8 <0.0001 POI-diagnosis(n) Clinical 64 AXR 65 Gastrograffin 65 CT scan 124 90-Day-mortality(n) 20 90 NS Survival rates(%) 1styear 88.4 87.1 4thyear 72.3 70.3 Logrank 8thyear 57.4 57.8 p=NS 12thyear 44.7 49.3 (uncensored) 16thyear 37.4 41.0 Conclusion POI occurred in 15.6 % of all CRC-resections at our instuition. Diagnosis of POI was made on day-5 (predominantly radiologically), requiring 3-days of NG-decompression, prolonged ileus (>5 days) required parenteral nutrition. Causes of POI is multi-factorial, resulting in delayed discharge & increased healthcare-costs. Motility-enhancing-drugs (pro-kinetics), vagus-nerve stimulation may help to reduce POI.