Defunctioning Ileostomy Is a Key Risk Factor for Small Bowel Obstruction After Colorectal Cancer Resection

Background/aim: Early postoperative small bowel obstruction (EPSBO) prolongs hospital stays after surgery. This study aimed to evaluate the risk factors for EPSBO associated with colorectal cancer resection.

Patients And Methods: We retrospectively compared the clinical variables of patients with EPSBO (n=37) and those without (n=812) after primary tumor resection for colorectal cancer at our hospital between January 2010 and December 2015.

Results: In multivariate analysis, significant differences between the two groups was found in male sex, open surgery, and defunctioning ileostomy (DI) placement (p=0.024, p<0.0001, and p=0.023, respectively), but not for colostomy placement. Of 16 patients with DI who developed EPSBO, 13 (81.3%) cases resulted from obstruction of the stomal outlet.

Conclusion: Male sex, open surgery, and DI placement are risk factors for EPSBO after colorectal cancer resection. For patients with placement of DI, obstruction of the stomal outlet should be carefully considered.