Analysis Of Risk Factors And Preventive Measures For Intestinal Obstruction After Laparoscopic Radical Resection Of The Bladder

Objective: To explore the risk factors and prevention measures of intestinal obstruction after laparoscopic radical resection of the bladder.Methods: In the retrospective study,105 patients who received laparoscopic radical cystectomy from January 2015 to March 2018.The correlation between postoperative intestinal obstruction and clinical characteristics of the patients was collected and analyzed.Results:In 12 patients(11.43%),intestinal obstruction occurred after surgery.Compared with patients without intestinal obstruction,patients with intestinal obstruction were older(mean 68.03 vs.65.52,P=0.029),and BMI was larger(mean27.61 vs.24.72,P=0.006).The incidence of intestinal obstruction in patients with pelvic lymphadenectomy was higher.Patients were higher than those without pelvic lymphadenectomy(20.00% vs 6.15%,P=0.030).Postoperative intestinal obstruction and preoperative hemoglobin,operative time,estimated intraoperative blood loss,postoperative blood transfusion,postoperative electrolyte imbalance,postoperative albumin,tumor pathological staging and other factors were not correlated.Multivariate analysis showed age(OR=0.920,95% CI 0.824-0.968,P=0.014),BMI(OR=0.438,95% CI 0.269-0.716,P=0.002),pelvic lymph node dissection(OR=2.334,95%)There was a correlation between CI 1.323 to 4.435,P=0.035)and the incidence of postoperative intestinal obstruction.Conclusion:The incidence of intestinal obstruction after laparoscopic radical resection of the bladder was significantly associated with age and BMI pelvic lymphadenectomy.The risk of postoperative intestinal obstruction increases in elderly and obese patients,and the incidence of postoperative intestinal obstruction is higher in patients undergoing pelvic lymphadenectomy.Therefore,high-risk patients should be screened before surgery,and postoperative complicationsshould be reduced by strengthening perioperative management.