Incidence Of And Risk Factors For Postoperative Ileus in Patients Undergoing Gynecologic Cancer Surgery

ABSTRACT
Aim: Postoperative paralytic ileus delays the resumption of oral intake, prolongs hospital stays, reduces patient satisfaction, and increases hospitalization costs. This study aimed to determine the incidence of postoperative ileus and identify key associated risk factors in patients undergoing surgery for gynecologic malignancies.
Materials and Methods: This retrospective cohort study was conducted at the Gynecologic Oncology Clinic of Izmir City Hospital between October 15, 2023, and October 15, 2024. Clinical data from 240 patients who underwent surgery for gynecologic cancer were analyzed. Patients who developed postoperative ileus were compared with those who did not in terms of demographic, surgical, and clinical characteristics.
Results: The incidence of postoperative ileus was found to be 11.3%. Ascites was observed in 48.1% of patients with ileus, significantly higher than in those without (p<0.001). The risk of ileus increased significantly in cases with ascitic volume greater than 500 mL (p=0.003). A significant association was observed between the type of incision and ileus development; patients who underwent both supraumbilical and subumbilical incisions had a higher rate of ileus (p<0.001). The rate of ileus was 63.0% in patients who received blood transfusions, compared to only 12.2% in those who did not (p<0.001). Additional analgesic use was also significantly higher in patients with ileus (59.3%, p<0.001). No significant association was found between comorbidities such as diabetes or hypertension and ileus development. The hospital readmission rate was significantly higher among patients who developed ileus (p=0.024).
Conclusion: Ascites, incision type, transfusion requirement, and additional analgesic use were significantly associated with postoperative ileus in patients undergoing gynecologic oncology surgery. These findings may aid in the preoperative identification of high-risk patients, enabling individualized surgical planning and the development of targeted perioperative management strategies. Incorporating these findings into perioperative protocols may help reduce complications and enhance postoperative recovery.
Keywords: Analgesia, Ascites, Cancer Surgery, Ileus, Transfusion