Predictors and Impact of Ileus on Outcomes After Laparoscopic Right Colectomy: A Case-Control Study

Abstract

Background Ileus is a common complication of major abdominal surgery, including colorectal resection. The present study aimed to assess the predictors of ileus after laparoscopic right colectomy for colon cancer. Methods This study was a retrospective case-control analysis of a prospective IRB-approved database of patients who underwent laparoscopic right colectomy at the Department of Colorectal Surgery, Cleveland Clinic Florida. Patients who developed ileus after right colectomy were compared to patients without ileus to determine the risk factors of ileus. Results The present study included 270 patients with a mean age of 68.7 years. Thirty-six patients (13.3%) experienced ileus after laparoscopic right colectomy. The median duration of ileus was 6 days. Factors associated with ileus were age (71.6 vs 68.2 years, P = .158), emergency colectomy (11.1% vs 3.9%, P = .082), extended hemicolectomy (19.4% vs 6.8%, P = .021), green gastrointestinal anastomosis (GIA) 4.8mm staple height cartridge (19% vs 8.1%, P = .114), and longer operative time (177.9 vs 160.4 minutes, P = .157). The only independent predictor of ileus was extended colectomy (OR: 16.7, P = .003). Conclusions Increased age, emergency surgery, green GIA cartridge, and longer operative times were associated with ileus, yet the only independent predictor of ileus was extended right hemicolectomy.