FP3.11 - Postoperative ileus (POI) in colorectal cancer resections: A cohort study

Abstract

Abstract Aims Postoperative ileus (POI) has reported incidence of < 30 % in malignant colorectal surgery. POI leads to delayed recovery, increase morbidity, prolonged hepatization & increased healthcare costs. Aim of study is to assess management of POI at single centre. Methods Cohort study was carried out from Jan'2008 to Jan'2023. Descriptive demography & post-operative outcomes were evaluated for POI patients, with non-ileus used as controls. Results Ileus (n = 275) Non ileus (n = 1436) Mann Whitney U (p value) Age(yrs) 71.8 70.1 NS Sex(M:F) 191 : 84 766 : 670 < 0.0001 ASA(median) 2 2 NS BMI(kg/m2) 26.9 26.4 NS Elective () 209 1139 Emergency(n) 66 297 Laparoscopic(n) 140 819 Open(n) 135 617 LN harvest(n) 12 12 NS Complications (n) (%) Leaks 14 52 HAP 64 125 Anaemia (transfusions) 10 43 Wound infections 41 115 Collection 27 69 Sepsis 37 49 Operation time(mins) 186.0 172.8 < 0.05 LOS(days) 14 ± 6 7 ± 3.5 < 0.0001 POI onset(days) 5 ± 2 NG tube(days) 3 ± 1 POI diagnosis (n) Clinical 62 AXR 70 Gastrograffin 64 CT scan 113 Mortality (n) 30 day 10 48 60 day 16 68 90 day 18 80 Survival rates (%) 1st year 89.0 87.6 Logrank 5th year 73.5 70.5 P = NS 10th year 64.3 62.4 (uncensored) 15th year 62.1 59.2 Conclusion POI occurred in 15.6 % of all CRC resections. Prolonged operative time, resulted in ileus, but did not adversely affect survival. POI can be diagnosed clinically or radiologically. POI resulted in prolonged hospitalization. Early diagnosis & intervention (NG tube decompression, fasting, IV fluids, gastrograffin & prokinetics) is key to reducing the adversity of POI