eP723 - Perioperative Blood Transfusion Is an Independent Risk Factor for Ileus Following Minimally Invasive Elective Colectomy for Cancer

ePoster Presenter(s)

• 

  Yosef Nasseri, MD, FACS, FACRS

  General and colorectal surgeron
  Cedar-Sinai Medical Center
  Los Angeles, CA, United States

  All relevant financial disclosures have been managed and will be listed below.
  This individual has no relevant relationships with ineligible companies.

Author(s)

• KL

  Kristina La, BS

  research fellow
  SGLA
  Los Angeles, California, United States

  Disclosure information not submitted.
• AS

  Andrea Solis, MD

  research fellow
  sgla
  Los Angeles, California, United States

  Disclosure information not submitted.
• RM

  Rachel Ma, n/a

  research fellow
  SGLA
  Los Angeles, California, United States

  Disclosure information not submitted.
• 

  Vincent Xu, BS

  Research Fellow
  The Surgery Groups of LA
  University of California, Los Angeles
  Los Angeles, CA, United States

  All of the relevant financial relationships listed below have been mitigated.
  This individual has no financial relationships with ineligible companies.
• AS

  Abbas Smiley, MD, MSc, PhD

  Statistician
  SGLA
  Los Angeles, California, United States

  Disclosure information not submitted.
• JE

  Joshua Ellenhorn, MD

  surgeon
  SGLA
  Los Angeles, California, United States

  Disclosure information not submitted.
• 

  Sean J. langenfeld, MD (he/him/his)

  Colon and Rectal Surgeon
  University of Nebraska Medical Center
  University of Nebraska Medical Center
  Omaha, Nebraska, United States

  All relevant financial disclosures have been managed and will be listed below.
  This individual has no financial relationships with ineligible companies.
• MB

  Moshe Barnajian, MD

  Surgeon
  SGLA
  Los Angeles, California, United States

  Disclosure information not submitted.

Purpose/Background: Postoperative ileus after colorectal surgery is a significant and costly problem. Our study aimed to investigate the correlation between perioperative (intraoperative and 72-hour postoperative) blood transfusion and postoperative ileus in patients who have undergone minimally invasive elective colectomy for colon cancer.Methods/Interventions: A retrospective study was conducted using the 2016-2020 American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database. Patients with colon cancer who underwent elective minimally invasive (laparoscopic and robotic) colectomy were selected for the study. Perioperative transfusion was defined as receiving one or more units of whole/packed RBCs within 72 hours of onset of operation. NSQIP does not include the number of units transfused. Ileus was defined by NSQIP as any nasogastric tube use or NPO status on postoperative day 4 or later. Using multivariable logistic regression with backward elimination, comorbidities plus intraoperative and postoperative variables were analyzed to identify risk factors for postoperative ileus.Results/Outcomes: 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). Additionally, there was no difference in rates of ileus following robotic and laparoscopic surgery (10.4% and 10.4%, respectively, P=0.8). Of the 2,960 patients (6.1% of total cohort) who had a blood transfusion, 516 (17.4%) had an ileus, whereas of the 45,768 patients (93.9% of total cohort) who did not have a blood transfusion, 4,569 (10.0%) had an ileus (P=0.0001). On multivariable logistic regression analysis accounting for demographic, comorbidities, operative time, surgical approach, perioperative blood transfusion, and all other potential risk factors for ileus (Table 1), patients with blood transfusions were 1.37 times more likely to develop an ileus (95%CI: 1.2-1.5, P=0.0001)Conclusion/

Discussion: Perioperative blood transfusion was an independent risk factor for ileus following minimally invasive operations for colon cancer.Multivariable logistic regression of variables associated with ileus