Risk factors for postoperative ileus after colorectal cancer surgery

Aim The aim was to assess the rate and independent risk factors of postoperative ileus after colorectal cancer surgery. Methods Three hundred consecutive patients underwent colorectal surgery for cancer at the State Scientific Centre of Coloproctology, Moscow, Russia, between November 2015 and August 2016. Postoperative ileus was diagnosed as an absence of intestinal function for 72 h or more after operation and was confirmed by plain radiography. Univariate and multivariate logistic regression of the tumour‐, patient‐ and treatment‐related factors was performed. All patients had epidural catheters with multimodal analgesia. Results Thirty‐nine patients (13%) had postoperative ileus. The variables associated with this condition in univariate analysis were age < 64 years (P = 0.02), male gender (P = 0.02), body mass index ≥ 25 kg/m2 (P = 0.02), moderate drinking (P = 0.02), heavier drinking (P < 0.0001), opioids (P = 0.02), history of abdominal operation (P = 0.003), firm extensive adhesions as a result of previous surgery (P = 0.005), multivisceral resection (P = 0.009), blood loss ≥ 150 ml (P = 0.006), haemotransfusion (P = 0.01) and open approach (P = 0.006). In the multivariate logistic regression, body mass index ≥ 26 kg/m2 (P = 0.008), opioids (P = 0.04), history of abdominal operation (P = 0.04) and adhesions (P = 0.03) were identified as independent risk factors. Conclusion Postoperative ileus is a common complication in colorectal surgery. The results of our study suggest at least two surgeon‐dependent risk factors, i.e. open approach and opioids in the postoperative period.