Risk factors for prolonged postoperative ileus after intracranial tumor surgery

Background: Prolonged postoperative ileus (PPOI) is the most frequent postoperative complication and significantly increases postoperative morbidity and medical costs. The objective of this study was to identify the incidence and independent risk factors of PPOI after intracranial tumor surgery, so as to allow for advanced planning to reduce the incidence of PPOI. Methods: : After retrospective review of data from patients who underwent intracranial tumor surgery from January 2018 to March 2021, a total of 1135 patients (447 males and 688 females; median age 51 [41–61] years) were included in the study. Clinical parameters were compared between patients with PPOI and those without PPOI. Multivariate logistic regression analysis was performed to identify independent risk factors associated with PPOI. Results: : In total, 121 of 1135 (10.7%) patients experienced PPOI. Operation time ≥4 h ( OR = 1.71, 95% CI 1.07–2.74, p = 0.03) and no flatus within postoperative 24 h ( OR = 1.86, 95% CI 1.25–2.76, p = 0.002) were the independent risk factors of PPOI. In addition, in-hospital length of stay was longer and medical costs were higher in patients with PPOI than in those without PPOI (all p < 0.001). Conclusions: : Independent risk factors for PPOI are operation time ≥4 h and no flatus within postoperative 24 h. Patients with these risk factors should be carefully monitored, and steps such as attempting to shorten the duration of surgery and utilizing measures to facilitate flatus should be taken to minimize the development of PPOI and prevent the occurrence of secondary adverse events. Trial registration: The study protocol was registered at Chinese Clinical Trial Registry (ChiCTR2200057468) on 13/03/2022.