Impact of post-operative paralytic ileus on post-operative outcomes after surgery for colorectal cancer: a single-institution, retrospective study

Matsui, Ryota; Nagakari, Kunihiko; Igarashi, Moeko; Hatta, Ryosuke; Otsuka, Takeshi; Nomoto, Jun; Kohama, Shintaro; Azuma, Daisuke; Takehara, Kazuhiro; Mizuno, Tomoya; Ohuchi, Masakazu; Oka, Shinichi; Yoshimoto, Jiro; Inaki, Noriyuki; Fukunaga, Masaki; Ishizaki, Yoichi

doi:10.1007/s00595-022-02499-3

Cited by 2 publications

(7 citation statements)

References 15 publications

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“…PPOI is associated with longer hospitalization and other postoperative complications [13,27]. This is a strain on health services and on the individual patient [4,[27][28].…”

Section: Socioeconomic Considerationsmentioning

confidence: 99%

“…Studies on POI following abdominal surgery most often include elective surgical procedures and very few studies exist solely investigating emergency surgery procedures [6][7][8][9][10][11][12][13]. In general there is differences in physiology in patients admitted and operated for an acute surgical condition compared with patients receiving elective surgery [14][15][16][17][18][19].…”

Section: Introductionmentioning

confidence: 99%

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Postoperative paralytic ileus following emergency surgery for bowel obstruction

Axelsen,

Lomholt,

Lauridsen

et al. 2024

Preprint

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Purpose Abdominal surgery is followed by various degrees of postoperative paralytic ileus (POI). If the condition persists for four days after surgery, it is referred to as prolonged POI (PPOI). PPOI significantly increases the risk for severe complications. We wished to access the proportion of PPOI in patients undergoing emergency surgery for acute intestinal obstruction (AIO) and investigate risk factors associated with development of PPOI. Methods Data were retrospectively collected from electronical patient journals from all patients undergoing surgery for AOI from 1st of January 2019 to 31st of December 2022 at the Department of Surgery, Aarhus University Hospital, Denmark. Results 101 (46%) of the patients operated for AIO developed PPOI. The mean LOS for patients with PPOI was 17.6 days versus 8.5 days for patients without PPOI. We identified several risk factors associated with development of PPOI in univariate analyses including age, hyperpotassiamia, high levels of carbamide, laparotomy, adhesiolysis, time in surgery, resection of small intestine, and use of temporary closure for second look. Patients with an active cancer diagnoseis were less likely to experience PPOI assessed in a multivariate analysis. We found no association between PPOI and 30 or 90-day mortality rates. Conclusion Almost half of patients who had emergency surgery for AIO developed PPOI. This is more frequent than reported incidences for elective intestinal surgery. Patients with PPOI had significantly longer LOS than patients without PPOI. Risk factors associated with PPOI included age, adhesiolysis, laparotomy, resection of small intestine, temporary vacuum assisted closure and time in surgery.

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“…PPOI is associated with longer hospitalization and other postoperative complications [13,27]. This is a strain on health services and on the individual patient [4,[27][28].…”

Section: Socioeconomic Considerationsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Postoperative paralytic ileus following emergency surgery for bowel obstruction

Axelsen,

Lomholt,

Lauridsen

et al. 2024

Preprint

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show abstract

“…NSQIP, CCI, ECI), ML algorithms can process and analyze extremely large amounts of patient data, identifying complex patterns and relationships influencing the risk of developing POI. Additionally, ML models can learn from large datasets and enhance their predictive accuracy over time [ 1 , 4 , 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

“…Predicting POI after colorectal surgery remains a challenge. Matsui et al identified several risk factors for POI, including right colon resection, pre-operative chemotherapy, antithrombotic drugs, and severe postoperative complications [ 6 ]. However, predictive accuracy remains limited due, in part, to inconsistent POI definitions and diagnostic methods across studies, leading to potential underdiagnosis, even for relatively common symptoms like absent defecation.…”

Section: Introductionmentioning

confidence: 99%

“…Vigilant postoperative surveillance for early signs of POI in high-risk patients could enable prompt intervention, shortening the duration of POI. POI is a common complication after colorectal surgery and can prolong hospital length of stay (LOS) [ 6 ]. In this study, we used several machine learning models to identify patient characteristics and comorbidities potentially associated with developing POI after colorectal surgery and compare ML model accuracy to existing predictive risk instruments [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

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Testing Machine Learning Models to Predict Postoperative Ileus after Colorectal Surgery

Brydges,

Chang,

Gan

et al. 2024

Current Oncology

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Background: Postoperative ileus (POI) is a common complication after colorectal surgery, leading to increased hospital stay and costs. This study aimed to explore patient comorbidities that contribute to the development of POI in the colorectal surgical population and compare machine learning (ML) model accuracy to existing risk instruments. Study Design: In a retrospective study, data were collected on 316 adult patients who underwent colorectal surgery from January 2020 to December 2021. The study excluded patients undergoing multi-visceral resections, re-operations, or combined primary and metastatic resections. Patients lacking follow-up within 90 days after surgery were also excluded. Eight different ML models were trained and cross-validated using 29 patient comorbidities and four comorbidity risk indices (ASA Status, NSQIP, CCI, and ECI). Results: The study found that 6.33% of patients experienced POI. Age, BMI, gender, kidney disease, anemia, arrhythmia, rheumatoid arthritis, and NSQIP score were identified as significant predictors of POI. The ML models with the greatest accuracy were AdaBoost tuned with grid search (94.2%) and XG Boost tuned with grid search (85.2%). Conclusions: This study suggests that ML models can predict the risk of POI with high accuracy and may offer a new frontier in early detection and intervention for postoperative outcome optimization. ML models can greatly improve the prediction and prevention of POI in colorectal surgery patients, which can lead to improved patient outcomes and reduced healthcare costs. Further research is required to validate and assess the replicability of these results.

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Impact of post-operative paralytic ileus on post-operative outcomes after surgery for colorectal cancer: a single-institution, retrospective study

Cited by 2 publications

References 15 publications

Postoperative paralytic ileus following emergency surgery for bowel obstruction

Postoperative paralytic ileus following emergency surgery for bowel obstruction

Testing Machine Learning Models to Predict Postoperative Ileus after Colorectal Surgery

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