The manifestations and risk factors of intestinal flora disorder after laparoscopic colon surgery:a single-center retrospective analysis
LI Gan-bin
WANG Chen-tong
ZHANG Xiao
QIU Xiaoyuan
CHEN Weijie
ZHANG Guannan
SUN Xiyu
NIU Beizhan
LU Junyang
XU Lai
WU Bin
XIAO Yi
QIU Huizhong
LIN Guo-le
Abstract：Objective To investigate the clinical characteristics and risk factors of intestinal flora disorder(IFD)after laparoscopic radical coloectomy.Methods A retrospective analysis was conducted on clinical data from 1073 patients who underwent laparoscopic radical coloectomy in the Department of General Surgery,Peking Union Medical College Hospital,from January 2019 to October 2023.Patients were categorized into the IFD group(n=97)and the non-IFD group(n=194)based on the occurrence of IFD,after propensity score matching.The clinical characteristics of patients in the two groups were compared,and conditional logistic regression analysis of binary variables was applied to identify the risk factors of IFD.Results The most common manifestations of IFD were diarrhea(50 patients,51.5%)and abdominal distension(38 patients,39.2%).Most patients achieved clinical recovery after adjusting the intestinal flora and receiving anti-infective treatment,with 23 patients(23.7%)and 11 patients(11.3%)requiring gastric tube and intestinal obstruction tube decompression,respectively.The most common timing for tube placement was postoperative days 4-6(73.9%)and postoperative days 7-12(63.6%).Multivariate logistic regression analysis revealed that preoperative intestinal obstruction(OR=4.88,95%CI 1.17-20.39,P=0.030)and early postoperative antibiotic(OR=7.94,95%CI 2.19-28.74,P=0.002)were independent risk factors for IFD,while enteral nutrition support before surgery(OR=0.06,95%CI 0.02-0.19,P＜0.001)was a protective factor of IFD.Conclusion The most common manifestations of IFD were diarrhea and abdominal distension,most patients could be managed conservatively.For patients with preoperative intestinal obstruction or early postoperative antibiotics,attention should be paid to IFD.Simultaneous enteral nutrition prior to surgery may reduce the risk of IFD.
Keywords：colorectal cancerlaparoscopic surgeryintestinal flora disorderclinical characteristicsrisk factors
Publication Date：2024-05-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 577-582 )