Work

Factors associated with postoperative ileus after laparoscopic radical resection for colorectal cancer and development and internal validation of a postoperative risk‑stratification nomogram

Year: 2026

Type: article

Abstract: Introduction Postoperative ileus (POI) is a common complication after colorectal surgery that delays recovery and prolongs hospitalization.Aim To identify factors associated with POI after laparoscopic radical resection for colorectal cancer and develop and internally validate a postoperative risk-stratification nomogram. Materials and methodsThis single-center retrospective study included 300 patients undergoing laparoscopic radical resection for colorectal cancer between January 2021 and March 2025.Patients were randomly assigned to development (n = 210) and validation (n = 90) cohorts.Multivariable logistic regression identified factors independently associated with POI.Model performance was evaluated using receiver operating characteristic, calibration, and decision curves.Results POI occurred in 23.8% and 22.2% of the development and validation cohorts, respectively.Previous abdominal surgery (OR = 3.031, 95% CI: 1.226-7.493,P = 0.02), delayed first postoperative ambulation (OR = 1.062, 95% CI: 1.028-1.098,P < 0.001), and elevated postoperative C-reactive protein (OR = 1.016, 95% CI: 1.004-1.028,P = 0.006) were independently associated with higher POI odds, whereas higher postoperative serum potassium was associated with lower odds (OR = 0.283, 95% CI: 0.089-0.898,P = 0.03).The nomogram achieved AUCs of 0.844 (95% CI: 0.783-0.905)and 0.762 (95% CI: 0.637-0.888)in the development and validation cohorts, respectively. ConclusionsThe nomogram showed acceptable internal performance and may support early postoperative POI risk reassessment and individualized management.External validation is required before broader clinical application.

Source: Videosurgery and Other Miniinvasive Techniques

DOI: 10.20452/wiitm.2026.18045