BACKGROUND: This study aimed to compare the incidence of postoperative ileus (POI) between end-to-end hand-sewn and side-to-side stapled ileo-ileal anastomoses and to identify independent risk factors associated with POI. METHODS: We conducted a retrospective analysis of patients who underwent radical cystectomy with urinary diversion at Ankara Etlik City Hospital between October 2022 and October 2024. Patients were categorized according to the anastomosis technique used: end-to-end hand-sewn or side-to-side stapled. Perioperative data, including demographic characteristics, comorbidities, preoperative laboratory parameters, operative variables, and postoperative outcomes, were collected. POI was defined as intolerance to oral intake accompanied by abdominal distension and absence of flatus or stool beyond postoperative day five, requiring medical or surgical management. Univariable and multivariable logistic regression analyses were performed to identify risk factors for POI. RESULTS: A total of 71 patients were included in the analysis. POI occurred in nine patients (23.7%) in the hand-sewn group and in four patients (12.1%) in the stapled group, indicating a significantly lower incidence in the stapled group. Multivariable analysis identified side-to-side stapled anastomosis as an independent protective factor against POI. Additional independent predictors included age ≥65 years, abnormal body mass index (BMI), preoperative constipation, hypoalbuminemia, and prolonged operative time. Receiver operat-ing characteristic (ROC) curve analysis demonstrated good predictive performance of the model. CONCLUSION: Side-to-side stapled ileo-ileal anastomosis is associated with a lower risk of POI compared to end-to-end hand-sewn anastomosis in patients undergoing radical cystectomy with urinary diversion.
Sandıkçı et al. (Thu,) studied this question.
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