A case–control study of risk factors for ileus and bowel obstruction following benign gynecologic surgery

Abstract

ObjectiveTo identify risk factors leading to the development of postoperative ileus and small-bowel obstruction (SBO) after benign gynecologic surgery. MethodsIn a multicenter case–control study across the United States, data were examined from women with International Classification of Diseases 9 (ICD-9) and Current Procedural Terminology (CPT) codes who underwent benign gynecologic surgery between January 2005 and June 2010 and subsequently developed an ileus or SBO. Each patient with ileus or SBO was matched to 2 control women who underwent the same benign gynecologic procedure but did not develop ileus or SBO. ResultsDuring the study period, 144 cases and 288 controls were identified. By conditional multivariate logistic regression, risk factors for ileus or SBO included cystotomy (odds ratio [OR], 8.7; 95% confidence interval [CI], 1.48–51.47), concomitant bowel surgery (OR, 4.3; 95% CI, 1.18–15.78), perioperative transfusion (OR, 2.9; 95% CI, 1.44–5.95), and lysis of adhesions (OR, 1.7; 95% CI, 1.03–2.83). ConclusionLysis of adhesions, concomitant bowel surgery, and perioperative complications such as blood transfusion and cystotomy were found to be risk factors for the development of ileus and/or SBO after benign gynecologic surgery.