Risk Factors of Delayed Recovery of Gastrointestinal Function After Ileostomy Reversal for Rectal Cancer Patients

Abstract

Purpose

The aim of this study was to identify the risk factors associated with delayed recovery of gastrointestinal function after ileostomy reversal for rectal cancer patients.

Methods

In this retrospective study, the data of rectal cancer patients who underwent ileostomy reversal from January 2018 to December 2019 at the Sixth Affiliated Hospital of Sun Yat-sen University were assessed to investigate potential risk factors of delayed flatus after ileostomy reversal.

Results

A total of 282 patients were eligible for this study. Postoperative first flatus time ranged from 1 to 9 days, of which 58.8% patients presented with delayed flatus that was longer than 3 days. Univariate analysis showed that delayed postoperative flatus was significantly associated with the length of postoperative hospital stay (P<0.001) and postoperative complications (P=0.037). Multivariate analysis showed that intravenous fluid infusion at postoperative day 1 (POD1) (OR=1.001, 95% CI: 1.001–1.002, P=0.001) and duration of stoma ≥6 months (OR=2.005, 95% CI:1.155–3.657, P=0.014) were independent risk factors for delayed flatus.

Conclusion

Increased intravenous fluid infusion at POD1 and duration of stoma ≥6 months were related to delayed recovery of gastrointestinal function after ileostomy reversal for rectal cancer patients.

Keywords:

• ileostomy reversal
• gastrointestinal function
• rectal cancer

Acknowledgments

We would like to extend our sincere gratitude to every researcher and participant who contributed to this study. This study was supported by Sun Yat-sen University Clinical Research 5010 Program (Grant Number: 2019021), National Natural Science Foundation of China (Grant Number: 81803163) and Natural Science Foundation of Guangdong Province (Grant Number: 2018A030310319). The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. Lili Chu, Hui Wang and Suyu Qiu are co-first authors for this study. Xiaoyan Huang and Rongkang Huang have contributed equally as corresponding authors.

Abbreviations

GIFR, gastrointestinal function recovery; ERAS, enhanced recovery after surgery; AL, Anastomotic leakage; POD1, postoperative day 1; ROC, receiver operating characteristic; AUC, area under the receiver-operating characteristic curve; IQR, interquartile range; OR, odds ratio; CI, confidence interval.

Data Sharing Statement

All datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Ethics Statement

This study was approved by the Ethical Committee of the Sixth Affiliated Hospital of Sun Yat-sen University (No. 2020ZSLYEC-139) and was conducted in accordance with the provisions of the World Medical Association’s Declaration of Helsinki of 1995 (revised in Tokyo, 2004). Because this was a retrospective study, informed consent was waived.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.