Analysis of Risk Factors for Ileus Following Radical Cystectomy: Is the Prolonged Use of a Nasogastric Tube Necessary?

Park, Hyoung Keun; Lee, Sang Wook; Yeo, Woon Geol; Kwak, Cheol; Byeon, Seok Soo; Kim, Hyeon Hoe; Lee, Eun Sik; Lee, Jong wook; Lee, Sang Eun

Abstract

PURPOSE: We examined the risk factors for postoperative ileus, and we investigated whether the duration of postoperative nasogastric tube (NGT) use affects the rate of postoperative ileus in patients undergoing radical cystectomy with urinary diversion.
MATERIALS AND METHODS
A total of 101 patients underwent radical cystectomy with urinary diversion from 1999 to 2003. We examined the demographic and perioperative variables of patients who developed postoperative ileus and those who did not. We divided the patients into two groups; a group of patients who had the NGT removed within 24 hours and a group of patients who had the NGT removed at first flatus. We compared the two groups for the incidence of ileus and for the clinical variables.
RESULTS
Postoperative ileus was observed in 23 patients (23%). The demographic data for both groups were not different in terms of age and the American Society of Anesthesiology (ASA) score. Also, the operative time, estimated blood loss, the type of diversion and the postoperative complication rates were not significantly different for the two groups (p>0.05). However, the risk of postoperative ileus was significantly higher for those patients who took a polyethylene glycol bowel preparation than for those who took a sodium phosphate bowel preparation (40%:18%, p=0.02). No significant difference in the prevalence of ileus was found between the patients whose NGT were removed within 1 days and those patients whose NGT was removed beyond 2 days (25%:22%, p>0.05).
CONCLUSIONS
The results of our study suggest that the use of sodium phosphate for bowel preparation may reduce postoperative ileus and that early NGT removal after cystectomy is not correlated with ileus.