Factors associated with postoperative ileus after laparoscopic radical resection for colorectal cancer and development and internal validation of a postoperative risk-stratification nomogram
- 1Department of Gastrointestinal Surgery, Loudi Central Hospital, Loudi, Hunan, China
Abstract
Introduction: Postoperative ileus (POI) is a common complication after colorectal surgery, delaying recovery and prolonging hospitalization. Aim: We aimed to identify factors associated with POI after laparoscopic radical resection for colorectal cancer and to develop and internally validate a postoperative risk-stratification nomogram. Materials and methods: This single-center retrospective study included 300 patients undergoing laparoscopic radical resection for colorectal cancer between January 2021 and March 2025. The patients were randomly assigned to the 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 (odds ratio [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 an elevated postoperative C-reactive protein level (OR, 1.016; 95% CI, 1.004–1.028; P = 0.006) were independently associated with higher POI odds, whereas an increased postoperative serum potassium level was associated with a lower probability (OR, 0.283; 95% CI, 0.089–0.898; P = 0.03). The nomogram achieved areas under the curve 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. Conclusions: The developed nomogram showed acceptable internal performance and may support early postoperative POI risk reassessment and individualized management. External validation is required before broader clinical application.
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BibTeX
@article{qin2026factors,
title = {{Factors associated with postoperative ileus after laparoscopic radical resection for colorectal cancer and development and internal validation of a postoperative risk-stratification nomogram}},
author = {Duoqin Qin and Weipeng Zhu and Jun Gong and Youxiong Shi and Hong Zhong and Xiwang Liao and Chongwen Deng and Duanyong Li},
journal = {Videosurgery and Other Miniinvasive Techniques},
year = {2026},
month = oct,
doi = {10.20452/wiitm.2026.18045},
url = {https://doi.org/10.20452/wiitm.2026.18045},
note = {CC BY-NC-SA 4.0},
}
RIS
TY - JOUR
TI - Factors associated with postoperative ileus after laparoscopic radical resection for colorectal cancer and development and internal validation of a postoperative risk-stratification nomogram
AU - Duoqin Qin
AU - Weipeng Zhu
AU - Jun Gong
AU - Youxiong Shi
AU - Hong Zhong
AU - Xiwang Liao
AU - Chongwen Deng
AU - Duanyong Li
PY - 2026
DA - 2026/10/01
JO - Videosurgery and Other Miniinvasive Techniques
DO - 10.20452/wiitm.2026.18045
UR - https://doi.org/10.20452/wiitm.2026.18045
AB - Introduction: Postoperative ileus (POI) is a common complication after colorectal surgery, delaying recovery and prolonging hospitalization. Aim: We aimed to identify factors associated with POI after laparoscopic radical resection for colorectal cancer and to develop and internally validate a postoperative risk-stratification nomogram. Materials and methods: This single-center retrospective study included 300 patients undergoing laparoscopic radical resection for colorectal cancer between January 2021 and March 2025. The patients were randomly assigned to the 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 (odds ratio [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 an elevated postoperative C-reactive protein level (OR, 1.016; 95% CI, 1.004–1.028; P = 0.006) were independently associated with higher POI odds, whereas an increased postoperative serum potassium level was associated with a lower probability (OR, 0.283; 95% CI, 0.089–0.898; P = 0.03). The nomogram achieved areas under the curve 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. Conclusions: The developed nomogram showed acceptable internal performance and may support early postoperative POI risk reassessment and individualized management. External validation is required before broader clinical application.
SN - 1895-4588
SN - 2299-0054
ER -