Correlates of prolonged postoperative ileus among patients undergoing colorectal surgeries / by Ola Toba Sayed ; supervised Dr. Hanan Ahmed Al-Sebaee , Dr. Lilian Isaac Iskander.

Thesis (M.Sc.)-Cairo University, 2023.

Bibliography: pages 112-120.

Background: Prolonged postoperative Ileus (PPOI) is one of the most common complications following colorectal surgeries which leads to increase postoperative morbidity, mortality and the length of hospital stay. Aim: The aim of this study was to assess correlates of PPOI among patients undergoing colorectal surgery at a university hospital. Design: A descriptive correlational research design was utilized in this study. Sample: A convenient sample of 60 adult male and female patients were recruited to fulfill the research aim. Setting: The study was conducted at selected colorectal and emergency surgery departments of Kasr El Eini Hospital affiliated to Cairo University. Tools: Three tools were developed, demographic data questionnaire, prolonged postoperative ileus correlates assessment questionnaire and prolonged postoperative ileus assessment tool. Results: The main study findings revealed that the incidence of PPOI occurred in
66.7 percent of patients. A statistically significant correlation were found between PPOI occurrence and laparotomy surgical approach, surgical procedure, preoperative prolonged duration of fasting for liquids more than 24 hours with p=0.1; preoperative duration of intravenous (IV) fluids administration, preoperative low hemoglobin (Hb), hematocrit (Hct) level with p=.02; preoperative antibiotics administration (p=.03); lack of preoperative teaching about recovery with p=.002; intraoperative bleeding with p=.05; intraoperative blood transfusion with p=.04; operation duration ≥3hours with p=.00; postoperative nasogastric tube (NGT) duration with p=.01; postoperative duration of fasting for liquids and for soft foods, and also postoperative IV fluids with p=.00; postoperative duration of urinary catheter with p=.001. Conclusion: Prolonged postoperative ileus is a complication with high incidence following colorectal surgery, its direct cause is not clear till now and even with no definite treatment. The preoperative correlates of PPOI are the laparotomy surgical approach, the colectomy procedure, IV fluids administration, low Hb and low Hct levels, prolonged fasting for liquids and teaching about preoperative recovery plan; the intraoperative correlates of PPOI are long operation duration, bleeding and blood transfusion, while postoperative correlates includes the use of NGT and its duration, duration of urinary catheter use, duration of fasting for liquids and soft foods and of IV fluids administration. Recommendations: Replication of the study on larger probability sample to achieve more generalizable results. Further research to determine the best practice for prevention and reduction of PPOI incidence; comprehensive education program including health team members and the patients regarding the guidelines of caring for colorectal surgery within the context of enhanced recovery after surgery (ERAS).

يعتب شلل االمعاء المستمر لفترة طويلة بعد العملية واحدة من أكثر المضاعفات شيوعاً بعد جراحات القولون والمستقيم بنسبة حدوث عالية تتراوح من 10٪ إلى 30٪، وهو عبارة عن تأخير في إستعادة الجهاز الهضمي لنشاطه بعد الجراحة و من
أعرضه الغثيان والقيء واالنتفاخ وعدم تحمل تناول أي شيء بالفم وغياب حركة األمعاء وخروج الريح . وقد ذكرت الدراسات
الحديثة أنه يرتبط بشكل كبير بعدوى الجرح ودخول المستشفى مرة /مرات أخرى وإعادة الجراحة وإرتفاع معدل الوفيات بعد
العملية وكذلك يرتبط باإلقامة لفترة طويلة في المستشفى مما يضع عبئًا اقتصادياً كبيراً على أنظمة الرعاية الصحية.
هناك نقص في الدراسات التي تُحقق في نسبة الحدوث و العوامل المؤدية لشلل األمعاء بين المرضى الذين يخضعون لجراحات
القولون والمستقيم في مصر، ألنه من الصعب تقديرها بسبب عدم وجود تقارير دقيقة وتعريف موحد، كما ٌوجد أيضاً أن نتائج
الدراسات التي تهدف إلى تحديد العوامل المرتبطة بحدوث شلل االمعاء متضاربة وغير متسقة، ولذلك فإن الهدف من الدرا سة
سة الحالية هو تحديد مترابطات طول فترة شلل االمعاء بعد العملية للمرضى الذين يخضعون لجراحات القولون والمستقيم.

Issues also as CD.

Text in English and abstract in Arabic & English.