Abstract
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.