AUTHOR=Tian Weiliang , Yan Ming , Xu Xin , Yao Zheng , Zhao Risheng 

TITLE=Risk Factors and Outcomes for Postoperative Ileus After Small Intestinal Fistula Excision in Patients With Diffuse Extensive Abdominal Adhesions

JOURNAL=Frontiers in Surgery

VOLUME=8

YEAR=2021

URL=https://www.frontiersin.org/journals/surgery/articles/10.3389/fsurg.2021.632241

DOI=10.3389/fsurg.2021.632241

ISSN=2296-875X

ABSTRACT=<p><bold>Purpose:</bold> The study aimed to investigate the risk factors for postoperative ileus (POI) after small intestinal fistula excision (SIFE) in patients with diffuse extensive abdominal adhesions.</p><p><bold>Methods:</bold> From October 2010 to December 2019, we enrolled patients who underwent SIFE and had diffuse extensive abdominal adhesions. Patients were divided into the POI group and the non-POI group according to its occurrence. We then investigated and analyzed the clinical characteristics of both groups.</p><p><bold>Result:</bold> A total of 247 patients were enrolled into the study. There were 100 patients in the POI group, and 147 patients in the non-POI group. A multi-variable logistic regression analysis revealed that blood loss during SIFE (OR = 1.001; 95% CI: 1.000–1.259; <italic>P</italic> = 0.012), postoperative lactate(OR = 1.212; 95% CI: 1.001–1.304; <italic>P</italic> = 0.015), grade V abdominal adhesions (OR = 2.518; 95% CI: 1.814–3.44; <italic>P</italic> = 0.024), and time for recovery of lactate &lt;2 mmol/L (OR = 2.079; 95% CI: 1.599–3.616; <italic>P</italic> = 0.026) were associated with POI. Moreover, POI was also associated with prolonged postoperative stay in the hospital (HR = 3.291; 95% CI: 2.511–4.172; <italic>P</italic> = 0.014).</p><p><bold>Conclusion:</bold> Blood loss during operation, grade V abdominal adhesions, positive fluid balance within 48 h of operation, and time for recovery of lactate were the risk factors for POI after SIFE in patients with diffuse extensive abdominal adhesions.</p>