대한대장항문학회

<b>Purpose:</b> The purposes of this study are to determine the incidence of postoperative ileus after colorectal surgery, to analyze its clinical features, and to identify the risk factors for its development. <br><br><b>Methods:</b> We reviewed the cases of 263 patients with mechanical ileus among 3,237 patients who underwent colorectal surgery in our clinic between June 1989 and December 2000. <br><br><b>Results:</b> A total of 263 (8.1%) patients of postoperative ileus were documented, 193 (73.4%) cases occurred during the 1st. year. Postoperative ileus is influenced by the initial site of surgery; the rectum has more impact than the colon (P=0.028). The causes of postoperative ileus were adhesion, recurrence of cancer, and parastomal hernia. Adhesion (81.1%) was the most common cause of ileus, and cancer recurrence (18.0%) was the second. However, in postoperative ileus requiring surgery, cancer recurrence increased with time (≤1 year: 10%; 1～2 years: 23.5%; ＞2 year: 58.1%). The cases receiving postoperative adjuvant radiation therapy presented a significant increase in the incidence of postoperative ileus (10.3% vs 6.7% P=0.01) and in the requirement for surgical treatment (4.6% vs 2.7%, P=0.04). Patients with a temporary stoma presented a significant increase in the incidence of postoperative ileus than patients with a permanent stoma (P=0.001). The frequency of prior episodes of ileus was the strongest predictor of recurrence. <br><br><b>Conclusions:</b> There is a high risk of adhesion-related problems after colorectal surgery. The risk factors are associated with rectal surgery, postoperative radiation therapy, and a temporary stoma. J Korean Soc Coloproctol 2003; 19:354-359