Risk Factors Of Postoperative Ileus In Gynecological Malignant Tumor Surgery: A Meta-analysis

Objective:Intestinal obstruction is a common postoperative complication in patients with gynecological malignant tumors,which may cause intestinal strangulation and necrosis,intestinal perforation,and even shock,which seriously threatens the life and health of patients.This study with the purpose of investigating the risk factors of Postoperative Ileus(POI)in patients with gynecological malignant tumors by systematic review,so as to provide evidence-based basis for clinical medical staff to prevent and reduce the occurrence of postoperative intestinal obstruction.Methods:Pub Med,Cochrane Library,Embase,Web of Science,CBM,CNKI,Wanfang and VIP electronic databases were used to search for studies on the risk factors of POI in patients with gynecological malignant tumors from the establishment of the database to March 2023.Revman 5.4 software was used for meta-analysis of the included studies.Results:A total of 7 case-control studies were included,and 24 risk factors were stud ied.Meta-analysis results showed that older age(OR= 1.76,95% CI=1.06～2.92,P=0.03),no preoperative bowel preparation(OR=2.05,95%CI=1.97～2.13,P<0.00001),l onger op-eration time(OR=1.83,95%CI=1.14～2.93,P=0.01),open surgery OR cytor eductive su-rgery(OR=2.56,95%CI=2.22～2.96,P<0.00001),hypoproteinemia(OR=1.86,95%CI=1.23～2.81,P=0.003),hypokalemia(OR=2.79,95%CI=2.28～3.42,P<0.00001),history of pelvic OR abdominal surgery(OR=2.61,95%CI=1.39～4.93,P=0.003)were the risk factors for postoperative intestinal obstruction in patients with gyne cological malignant tumors.Red blood cell transfusion(OR=0.45,95%CI=0.34～0.60,P<0.00001)was a protective factor for POI in patients with gynecological malig nant tumors.Conclusion:Old age,no preoperative bowel preparation,long operation time,open surgery or tumor debulking surgery,hypoproteinemia,hypokalemia,and history of pelvic or abdominal surgery are all risk factors for POI in patients with gynecological malignant tumors.Red blood cell transfusion is a protective factor for postoperative intestinal obstruction in patients with gynecological malignant tumors.Clinical staff can reduce the risk of postoperative intestinal obstruction in patients with gynecological malignant tumors by selecting controllable factors through this study combined with clinical practice.