Risk Factors of Ileus following Radical Cystectomy / 대한비뇨기과학회지

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). CONCLUSIONS: Ileus following radical cystectomy was more frequent in patients with a high ASA score. Older aged men tend to have ileus after radical cystectomy.