근치적 방광적출술 후 장폐색을 일으키는 인자에 대한 연구
Risk Factors of Ileus following Radical Cystectomy
정해원, 조성태, 이영구,
소속 상세정보
정해원 ( Jung Hae-Won )
한림대학교 의과대학 비뇨기과학교실
조성태 ( Cho Sung-Tae )
한림대학교 의과대학 비뇨기과학교실
이영구 ( Lee Young-Goo )
한림대학교 의과대학 비뇨기과학교실
KMID : 0358320070480121236
Abstract
Purpose : Ileus is the most common complication following radical cystectomy. Ileus causes prolonged fasting, significant patient discomfort and prolongation of the hospital stay. We retrospectively examined the risk factors for ileus following radical cystectomy.
Materials and Methods : Between January, 2000 and June, 2007, 59 patients underwent radical cystectomy with urinary diversion at our institution. 30 patients underwent creation of an ileal conduit and 29 patients underwent orthotopic bladder substitution with using ileum. Ileus was defined as the persistent absence of flatus on postoperative day 7 or the generalized findings of ileus on simple abdominal film. The potential risk factors were analyzed between the ileus and non ileus groups, including the patient’s age and gender, the American Society of Anesthesiologists score, the preoperative serum albumin level, prior abdominal surgery, the operative time, combined operation, the estimated blood loss, the type of urinary diversion, use of N2O, use of intestinal stapler, complications, the ICU stay and the pathologic stage and grade.
Results : 24%(14/59) of patients had postoperative ileus. The difference of the ASA score between the two groups was statistically significant (p=0.03). Patients with ileus(67.5±7.2) were older than the non-ileus patients(63.0±9.4)(p=0.103). Ileus was more frequent in men(29.5%, 13/ 44) than in women(6.6%, 1/15)(p=0.09).
Conclusion : Ileus following radical cystectomy was more frequent in patients with a high ASA score. Older aged men tend to have ileus after radical cystectomy. (Korean J Urol 2007;48:1236-1241)
키워드
Intestinal obstruction;Cystectomy;Bladder cancer
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