Perioperative blood transfusion is an independent risk factor for ileus following minimally invasive elective colectomy for cancer.

Abstract

We aim to investigate the correlation between perioperative blood transfusion and postoperative ileus in patients who have undergone minimally invasive elective colectomy for cancer. This is a retrospective study using the 2016-2020 American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database. Patients with colon cancer who underwent elective laparoscopic or robotic colectomy were selected. Perioperative transfusion was defined as receiving one or more units of whole/packed RBCs within 72 h of onset of operation. Using multivariable logistic regression with backward elimination, comorbidities, and intraoperative and postoperative variables were analyzed to identify risk factors for postoperative ileus. 48,728 patients were included with a mean age of 64.7 years, 52.3% were males, and a mean BMI of 28.8 kg/m². Overall, men had a higher rate of ileus than women (13 and 7.6%, respectively, P = 0.0001). There was no difference in rates of ileus following robotic and laparoscopic surgery (10.4 and 10.4%, respectively, P = 0.8). Of the 2960 patients who had a blood transfusion, 516 (17.4%) had an ileus, whereas of the 45,768 patients who did not have a blood transfusion, 4569 (10.0%) had an ileus (P = 0.0001). On multivariable logistic regression analysis, patients with blood transfusions were 1.37 times more likely to develop an ileus (95% CI 1.2-1.5, P = 0.0001). Perioperative blood transfusion is an independent risk factor for ileus following minimally invasive colectomy for cancer.