The Incidence of Prolonged Postoperative Ileus After Laparoscopic Colorectal Surgery—Does ERAS Protocol Bring Anything New?

A substantial percentage of patients undergoing colorectal surgery develop prolonged postoperative ileus (PPOI). Since the data on its incidence and risk factors in patients undergoing laparoscopic colorectal surgery with ERAS protocol are sparse, we aimed to analyse them in a group of 295 consecutive patients operated on laparoscopically for colorectal cancer. The study was a prospective observation of 295 patients. In all of them, the 16-item ERAS protocol was applied. The primary outcome was the occurrence of PPOI. Secondary outcomes were risk factors of PPOI. PPOI incidence rate was 9.8%. In 8 (27.6% of PPOI group) patients, it was secondary to other underlying complication. In the remaining 21 (72.4% of PPOI group) cases, it was primary. In 80.9% cases, it resolved completely by five postoperative days. Using univariate regression analysis, we observed that only the female sex (OR 2.71) was an independent predictor of PPOI development, whereas age >65 years was associated with a lower risk (OR 0.33). Also patients after procedures involving handling the small bowel were more likely to develop PPOI (OR 2.65). The remaining demographic and perioperative parameters were not statistically significant. The incidence of PPOI in patients after laparoscopy with ERAS protocol is low and usually resolves within 5 days. However, longer PPOI may indicate underlying complications. Traditional risk factors for PPOI seem to play a limited role in its development.