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Incidence of and risk factors for postoperative ileus in women undergoing primary staging and debulking for epithelial ovarian carcinoma.
- Source :
-
Gynecologic oncology [Gynecol Oncol] 2012 Jun; Vol. 125 (3), pp. 614-20. Date of Electronic Publication: 2012 Feb 24. - Publication Year :
- 2012
-
Abstract
- Objective: Thorough primary cytoreduction for epithelial ovarian carcinoma (EOC) improves survival. The incidence of postoperative ileus (POI) in these patients may be underreported because of varying POI definitions and the evolving, increasingly complex contemporary surgical approach to EOC. We sought to determine the current incidence of POI and its risk factors in women undergoing debulking and staging for EOC.<br />Methods: We retrospectively identified the records of women who underwent primary staging and cytoreduction for EOC between 2003 and 2008. POI was defined as a surgeon's diagnosis of POI, return to nothing-by-mouth status, or reinsertion of a nasogastric tube. Perioperative patient characteristics and process-of-care variables were analyzed. Univariate analyses were used to identify POI risk factors; variables with P ≤.20 were included in multivariate analysis.<br />Results: Among 587 women identified, the overall incidence of POI was 30.3% (25.9% without bowel resection, 38.5% with bowel resection; P=.002). Preoperative thrombocytosis, involvement of bowel mesentery with carcinoma, and perioperative red blood cell transfusion were independently associated with increased POI. Postoperative ibuprofen use was associated with decreased POI risk. Women with POI had a longer length of stay (median, 11 vs 6 days) and increased time to recovery of the upper (7.5 vs 4 days) and lower (4 vs 3 days) gastrointestinal tract (P<.001 for each).<br />Conclusions: The rate of POI is substantial among women undergoing staging and cytoreduction for EOC and is associated with increased length of stay. Modifiable risk factors may include transfusion and postoperative ibuprofen use. Alternative interventions to decrease POI are needed.<br /> (Copyright © 2012 Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Aged
Aged, 80 and over
Carcinoma, Ovarian Epithelial
Fallopian Tube Neoplasms pathology
Fallopian Tube Neoplasms surgery
Female
Humans
Middle Aged
Neoplasm Staging
Peritoneal Neoplasms pathology
Peritoneal Neoplasms surgery
Retrospective Studies
Risk Factors
Gynecologic Surgical Procedures adverse effects
Ileus etiology
Neoplasms, Glandular and Epithelial pathology
Neoplasms, Glandular and Epithelial surgery
Ovarian Neoplasms pathology
Ovarian Neoplasms surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1095-6859
- Volume :
- 125
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Gynecologic oncology
- Publication Type :
- Academic Journal
- Accession number :
- 22370599
- Full Text :
- https://doi.org/10.1016/j.ygyno.2012.02.027