Intraoperative maneuvers may affect the development of early postoperative small bowel obstruction after laparoscopic colorectal cancer surgery: Multicenter prospective cohort study

Nakamura, Yuki; Matsuda, Kenji; Yokoyama, Shozo; Hotta, Tsukasa; Takifuji, Katsunari; Yamamoto, Manabu; Itō, Makoto; Tominaga, Toshiji; Horiuchi, Tetsuya; Kinoshita, Hiroyuki; Tsubakihara, Hideaki; Noguchi, Kohei; Yamaguchi, Kazuya; Shimada, Kosuke; Oku, Yoshimasa; Yamaue, Hiroki

doi:10.1016/j.ijsu.2021.01.007

Cited by 7 publications

(14 citation statements)

References 13 publications

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“…The findings of the current study showed that the probability of EPSBO was significantly higher in males than in females, which was consistent with previous studies [ 4 , 6 , 12 , 13 , 17 ]. Male patients may be more prone to EPSBO due to narrow pelvic space and high visceral fat content.…”

Section: Discussionsupporting

confidence: 93%

“…EPSBO is the most frequent complication in colorectal surgery [ 12 ]. Previous studies reported an EPSBO incidence ranging from 4.5 to 12.8% [ 4 ]. The diagnosis of EPBO is complicated due to overlap between the symptoms and signs of postoperative patients and those of postoperative recovery, as well as the use of analgesics, which explains the wide range in incidence [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

“…In total, 424 patients who underwent right colectomy in the Second Affiliated Hospital of Fujian Medical University from January 2014 to March 2021 were retrospectively recruited. EPSBO can be diagnosed if the patient has three or more clinical symptoms such as abdominal pain, abdominal distention, nausea, vomiting, no exhaust, or defecation for more than 24 h within 30 days after colectomy, or signs such as abdominal tenderness, hyperactivity, metal sound, abdominal X-ray, or CT examination indicates small intestinal dilatation and gas-liquid level [ 4 ]. The inclusion criteria included patients who underwent right colectomy, which was confirmed as malignant by pathology.…”

Section: Methodsmentioning

confidence: 99%

“…The inclusion criteria included patients who underwent right colectomy, which was confirmed as malignant by pathology. The exclusion criteria included a previous history of intraperitoneal radiotherapy, chemotherapy, or inflammatory bowel disease [ 4 , 13 ]. Recruited study patients were divided into two groups: the EPSBO and no EPSBO groups.…”

Section: Methodsmentioning

confidence: 99%

“…In particular, early postoperative small bowel obstruction (EPSBO) is a complication of colorectal cancer surgery. The incidence of EPSBO after colorectal cancer surgery was 4.5–12.8% and that the incidence of EPSBO after right hemicolectomy remained high without declining [ 4 , 5 ]. Previous studies also reported that EPSBO inhibited early oral intake and early ambulation, prolonged postoperative hospital stay, increased cost of hospitalization, and reduced utilization rate of hospital beds [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

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Novel nomogram for predicting risk of early postoperative small bowel obstruction after right colectomy for cancer

et al. 2022

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Background Early postoperative small bowel obstruction (EPSBO) is a common complication after colorectal cancer surgery. Few studies have specifically studied risk factors for early small bowel obstruction after right colectomy, especially in establishing predictive models. The purpose of the current study was to establish an effective nomogram to predict the incidence of EPSBO after right colectomy. Methods The current study retrospectively analyzed data from a total of 424 patients who underwent right colectomy in a local hospital from January 2014 to March 2021. A logistic regression model was used to identify potential risk factors for EPSBO after right colectomy. A nomogram was established by independent risk factors, and the prediction performance of the model was evaluated using an area under the receiver operating characteristic (ROC) curve and calibration chart. Results A total of 45 patients (10.6%) developed early small bowel obstruction after right colectomy. Male sex, emergency operation, history of abdominal surgery, open surgery, long operative time, anastomotic leakage, and preoperative albumin were closely related to EPSBO. Analysis of postoperative rehabilitation indices showed that EPSBO remarkably slowed the postoperative rehabilitation speed of patients. Multivariate logistic regression analysis showed that male sex, open surgery, operative time, and anastomotic leakage were independent risk factors (P < 0.05), and the operation time had the greatest impact on EPSBO. On the basis of multivariate logistic regression, a nomogram was constructed, which showed moderate accuracy in predicting EPSBO, with a C-statistic of 0.716. The calibration chart showed good consistency between the predicted probability and ideal probability. Conclusion The current study constructed a nomogram based on the clinical data of patients who underwent right colectomy, which had moderate predictability and could provide reference value for clinicians to evaluate the risk of EPSBO.

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