Risk factors for postoperative ileus after urologic laparoscopic surgery
김명준, 민경은, 유구한, 장성구, 전승현,
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김명준 ( Kim Myung-Joon )
Kyung Hee University School of Medicine Department of Urology
민경은 ( Min Gyeong-Eun )
Kyung Hee University School of Medicine Department of Urology
유구한 ( Yoo Koo-Han )
Kyung Hee University School of Medicine Department of Urology
장성구 ( Chang Sung-Goo )
Kyung Hee University School of Medicine Department of Urology
전승현 ( Jeon Seung-Hyun )
Kyung Hee University School of Medicine Department of Urology
KMID : 0371320110800060384
Abstract
Purpose: Although its incidence has decreased with the widespread use of less invasive surgical techniques including laparoscopic surgery, postoperative ileus remains a common postoperative complication. In the field of urologic surgery, with the major exception of radical cystectomy, few studies have focused on postoperative ileus as a complication of laparoscopic surgery. The present study aims to offer further clues in the management of postoperative ileus following urological laparoscopic surgery through an assessment of the associated risk factors.
Methods: The medical records of 267 patients who underwent laparoscopic surgery between February 2004 and November 2009 were reviewed. After excluding cases involving radical cystectomy, combined surgery, open conversion, and severe complications, a total of 249 patients were included for this study. The subjects were divided into a non-ileus group and an ileus group. The gender and age distribution, duration of anesthesia, American Society of Anesthesiologists Physical Status Classification Score, body mass index, degree of operative difficulty, presence of complications, surgical procedure and total opiate dosage were compared between the two groups.
Results: Of the 249 patients, 10.8% (n = 27) experienced postoperative ileus. Patients with ileus had a longer duration of anesthesia (P = 0.019), and perioperative complications and blood loss were all correlated with ileus (P = 0.000, 0.004, respectively). Multiple linear regression analysis showed that the modified Clavien classification was an independent risk factor for postoperative ileus (odds ratio, 5.372; 95% confidence interval, 2.084 to 13.845; P = 0.001).
Conclusion: Postoperative ileus after laparoscopic urologic surgery was more frequent in patients who experienced more perioperative complications.
키워드
Urology; Laparoscopy; Complication; Ileus
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