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General Postoperative Complications

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Abstract

Postoperative complications are a potential outcome of any colorectal operation. These complications can occur in any organ system, but the most common ones include ileus, bleeding, and surgical site infections. Numerous strategies exist to reduce the harmful effects of complications including optimization of modifiable risk factors preoperatively and early identification/treatment of complications if they occur. Ultimately, all colorectal surgeons should be equipped with the knowledge, skills, and experience to manage general postoperative complications.

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References

  1. Schilling PL, Dimick JB, Birkmeyer JD. Prioritizing quality improvement in general surgery. J Am Coll Surg. 2008;207(5):698–704.

    PubMed  Google Scholar 

  2. Longo WE, et al. Risk factors for morbidity and mortality after colectomy for colon cancer. Dis Colon Rectum. 2000;43(1):83–91.

    CAS  PubMed  Google Scholar 

  3. Tevis SE, Kennedy GD. Postoperative complications: looking forward to a safer future. Clin Colon Rectal Surg. 2016;29(3):246–52.

    PubMed  PubMed Central  Google Scholar 

  4. Scarborough JE, et al. Associations of specific postoperative complications with outcomes after elective colon resection: a procedure-targeted approach toward surgical quality improvement. JAMA Surg. 2017;152(2):e164681.

    PubMed  Google Scholar 

  5. Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240(2):205–13.

    PubMed  PubMed Central  Google Scholar 

  6. Clavien PA, et al. The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg. 2009;250(2):187–96.

    PubMed  Google Scholar 

  7. Slankamenac K, et al. The comprehensive complication index: a novel continuous scale to measure surgical morbidity. Ann Surg. 2013;258(1):1–7.

    PubMed  Google Scholar 

  8. Strasberg SM, Linehan DC, Hawkins WG. The accordion severity grading system of surgical complications. Ann Surg. 2009;250(2):177–86.

    PubMed  Google Scholar 

  9. Khuri SF, et al. The Department of Veterans Affairs' NSQIP: the first national, validated, outcome-based, risk-adjusted, and peer-controlled program for the measurement and enhancement of the quality of surgical care. National VA Surgical Quality Improvement Program. Ann Surg. 1998;228(4):491–507.

    CAS  PubMed  PubMed Central  Google Scholar 

  10. Khuri SF, et al. Determinants of long-term survival after major surgery and the adverse effect of postoperative complications. Ann Surg. 2005;242(3):326–41; discussion 341–3.

    PubMed  PubMed Central  Google Scholar 

  11. Lawson EH, et al. Association between occurrence of a postoperative complication and readmission: implications for quality improvement and cost savings. Ann Surg. 2013;258(1):10–8.

    PubMed  Google Scholar 

  12. Zogg CK, et al. Rethinking priorities: cost of complications after elective colectomy. Ann Surg. 2016;264(2):312–22.

    PubMed  Google Scholar 

  13. Tevis SE, et al. Postoperative complications in patients with rectal cancer are associated with delays in chemotherapy that lead to worse disease-free and overall survival. Dis Colon Rectum. 2013;56(12):1339–48.

    PubMed  Google Scholar 

  14. Yang R, Wolfson M, Lewis MC. Unique aspects of the elderly surgical population: an anesthesiologist's perspective. Geriatr Orthop Surg Rehabil. 2011;2(2):56–64.

    PubMed  PubMed Central  Google Scholar 

  15. Kirchhoff P, Dincler S, Buchmann P. A multivariate analysis of potential risk factors for intra- and postoperative complications in 1316 elective laparoscopic colorectal procedures. Ann Surg. 2008;248(2):259–65.

    PubMed  Google Scholar 

  16. Aquina CT, et al. The impact of age on complications, survival, and cause of death following colon cancer surgery. Br J Cancer. 2017;116(3):389–97.

    PubMed  PubMed Central  Google Scholar 

  17. Weerink LBM, et al. Long-term survival in octogenarians after surgical treatment for colorectal cancer: prevention of postoperative complications is key. Ann Surg Oncol. 2018;25(13):3874–82.

    PubMed  PubMed Central  Google Scholar 

  18. Kunitake H, et al. Caring for octogenarian and nonagenarian patients with colorectal cancer: what should our standards and expectations be? Dis Colon Rectum. 2010;53(5):735–43.

    PubMed  Google Scholar 

  19. Ostermann S, et al. Randomized controlled trial of enhanced recovery program dedicated to elderly patients after colorectal surgery. Dis Colon Rectum. 2019;62(9):1105–16.

    PubMed  Google Scholar 

  20. Al-Taki M, et al. Effect of gender on postoperative morbidity and mortality outcomes: a retrospective cohort study. Am Surg. 2018;84(3):377–86.

    PubMed  Google Scholar 

  21. Lipska MA, et al. Anastomotic leakage after lower gastrointestinal anastomosis: men are at a higher risk. ANZ J Surg. 2006;76(7):579–85.

    PubMed  Google Scholar 

  22. Tan WP, et al. American Society of Anesthesiologists class and Charlson's comorbidity index as predictors of postoperative colorectal anastomotic leak: a single-institution experience. J Surg Res. 2013;184(1):115–9.

    PubMed  Google Scholar 

  23. Tian Y, et al. Age-adjusted charlson comorbidity index score as predictor of prolonged postoperative ileus in patients with colorectal cancer who underwent surgical resection. Oncotarget. 2017;8(13):20794–801.

    PubMed  PubMed Central  Google Scholar 

  24. Ouellette JR, Small DG, Termuhlen PM. Evaluation of Charlson-Age Comorbidity Index as predictor of morbidity and mortality in patients with colorectal carcinoma. J Gastrointest Surg. 2004;8(8):1061–7.

    PubMed  Google Scholar 

  25. Krarup PM, et al. Association of comorbidity with anastomotic leak, 30-day mortality, and length of stay in elective surgery for colonic cancer: a Nationwide Cohort Study. Dis Colon Rectum. 2015;58(7):668–76.

    PubMed  Google Scholar 

  26. Kozol RA, et al. Minimizing risk in colon and rectal surgery. Am J Surg. 2007;194(5):576–87.

    PubMed  Google Scholar 

  27. Hahn EE, et al. Understanding comorbidity profiles and their effect on treatment and survival in patients with colorectal cancer. J Natl Compr Cancer Netw. 2018;16(1):23–34.

    Google Scholar 

  28. Franko J, et al. The influence of prior abdominal operations on conversion and complication rates in laparoscopic colorectal surgery. JSLS. 2006;10(2):169–75.

    PubMed  PubMed Central  Google Scholar 

  29. Parker MC. Epidemiology of adhesions: the burden. Hosp Med. 2004;65(6):330–6.

    PubMed  Google Scholar 

  30. Beattie AH, et al. A randomised controlled trial evaluating the use of enteral nutritional supplements postoperatively in malnourished surgical patients. Gut. 2000;46(6):813–8.

    CAS  PubMed  PubMed Central  Google Scholar 

  31. Kondrup J, et al. Nutritional risk screening (NRS 2002): a new method based on an analysis of controlled clinical trials. Clin Nutr. 2003;22(3):321–36.

    PubMed  Google Scholar 

  32. Almasaudi AS, et al. The relation between Malnutrition Universal Screening Tool (MUST), computed tomography-derived body composition, systemic inflammation, and clinical outcomes in patients undergoing surgery for colorectal cancer. Am J Clin Nutr. 2019;110(6):1327–34.

    PubMed  Google Scholar 

  33. Braga M, et al. Preoperative oral arginine and n-3 fatty acid supplementation improves the immunometabolic host response and outcome after colorectal resection for cancer. Surgery. 2002;132(5):805–14.

    PubMed  Google Scholar 

  34. Gianotti L, et al. A randomized controlled trial of preoperative oral supplementation with a specialized diet in patients with gastrointestinal cancer. Gastroenterology. 2002;122(7):1763–70.

    CAS  PubMed  Google Scholar 

  35. Thornblade LW, et al. Preoperative immunonutrition and elective colorectal resection outcomes. Dis Colon Rectum. 2017;60(1):68–75.

    PubMed  PubMed Central  Google Scholar 

  36. Gustafsson UO, et al. Guidelines for Perioperative Care in Elective Colorectal Surgery: Enhanced Recovery After Surgery (ERAS((R))) Society Recommendations: 2018. World J Surg. 2019;43(3):659–95.

    CAS  PubMed  Google Scholar 

  37. Agodi A, et al. Risk of surgical site infection in older patients in a cohort survey: targets for quality improvement in antibiotic prophylaxis. Int Surg. 2015;100(3):473–9.

    PubMed  PubMed Central  Google Scholar 

  38. Baucom RB, et al. Smoking as dominant risk factor for anastomotic leak after left colon resection. Am J Surg. 2015;210(1):1–5.

    PubMed  Google Scholar 

  39. Bolckmans R, et al. Does smoking cessation reduce surgical recurrence after primary ileocolic resection for Crohn's disease? Dis Colon Rectum. 2020;63(2):200–6.

    PubMed  Google Scholar 

  40. Lindstrom D, et al. Effects of a perioperative smoking cessation intervention on postoperative complications: a randomized trial. Ann Surg. 2008;248(5):739–45.

    PubMed  Google Scholar 

  41. Sorensen LT, Karlsmark T, Gottrup F. Abstinence from smoking reduces incisional wound infection: a randomized controlled trial. Ann Surg. 2003;238(1):1–5.

    PubMed  PubMed Central  Google Scholar 

  42. Moller AM, et al. Effect of preoperative smoking intervention on postoperative complications: a randomised clinical trial. Lancet. 2002;359(9301):114–7.

    PubMed  Google Scholar 

  43. Thomsen T, Tonnesen H, Moller AM. Effect of preoperative smoking cessation interventions on postoperative complications and smoking cessation. Br J Surg. 2009;96(5):451–61.

    CAS  PubMed  Google Scholar 

  44. van Rooijen SJ, et al. Making patients fit for surgery: introducing a four pillar multimodal prehabilitation program in colorectal cancer. Am J Phys Med Rehabil. 2019;98(10):888–96.

    PubMed  Google Scholar 

  45. Leichtle SW, et al. Does preoperative anemia adversely affect colon and rectal surgery outcomes? J Am Coll Surg. 2011;212(2):187–94.

    PubMed  Google Scholar 

  46. Wilson MJ, et al. The role of preoperative iron deficiency in colorectal cancer patients: prevalence and treatment. Int J Color Dis. 2017;32(11):1617–24.

    CAS  Google Scholar 

  47. Quinn EM, et al. Correction of iron-deficiency anaemia in colorectal surgery reduces perioperative transfusion rates: a before and after study. Int J Surg. 2017;38:1–8.

    PubMed  Google Scholar 

  48. American Society of Anesthesiologists Task Force on Perioperative Blood, M. Practice guidelines for perioperative blood management: an updated report by the American Society of Anesthesiologists Task Force on Perioperative Blood Management*. Anesthesiology. 2015;122(2):241–75.

    Google Scholar 

  49. Roubenoff R. Sarcopenia: a major modifiable cause of frailty in the elderly. J Nutr Health Aging. 2000;4(3):140–2.

    CAS  PubMed  Google Scholar 

  50. Nakanishi R, et al. Sarcopenia is an independent predictor of complications after colorectal cancer surgery. Surg Today. 2018;48(2):151–7.

    PubMed  Google Scholar 

  51. Yang J, et al. A new diagnostic index for sarcopenia and its association with short-term postoperative complications in patients undergoing surgery for colorectal cancer. Color Dis. 2019;21(5):538–47.

    CAS  Google Scholar 

  52. Wang Y, et al. Has the prevalence of overweight, obesity and central obesity levelled off in the United States? Trends, patterns, disparities, and future projections for the obesity epidemic. Int J Epidemiol. 2020;

    Google Scholar 

  53. Hussan H, et al. Morbid obesity is associated with increased mortality, surgical complications, and incremental health care utilization in the peri-operative period of colorectal cancer surgery. World J Surg. 2016;40(4):987–94.

    PubMed  Google Scholar 

  54. Pikarsky AJ, et al. Is obesity a high-risk factor for laparoscopic colorectal surgery? Surg Endosc. 2002;16(5):855–8.

    CAS  PubMed  Google Scholar 

  55. Wahl TS, et al. The obese colorectal surgery patient: surgical site infection and outcomes. Dis Colon Rectum. 2018;61(8):938–45.

    PubMed  PubMed Central  Google Scholar 

  56. Gillis C, et al. Prehabilitation versus rehabilitation: a randomized control trial in patients undergoing colorectal resection for cancer. Anesthesiology. 2014;121(5):937–47.

    PubMed  Google Scholar 

  57. van Rooijen S, et al. Multimodal prehabilitation in colorectal cancer patients to improve functional capacity and reduce postoperative complications: the first international randomized controlled trial for multimodal prehabilitation. BMC Cancer. 2019;19(1):98.

    PubMed  PubMed Central  Google Scholar 

  58. Wilson MZ, Hollenbeak CS, Stewart DB. Laparoscopic colectomy is associated with a lower incidence of postoperative complications than open colectomy: a propensity score-matched cohort analysis. Color Dis. 2014;16(5):382–9.

    CAS  Google Scholar 

  59. Kennedy GD, et al. Laparoscopy decreases postoperative complication rates after abdominal colectomy: results from the national surgical quality improvement program. Ann Surg. 2009;249(4):596–601.

    PubMed  Google Scholar 

  60. Bilimoria KY, et al. Laparoscopic-assisted vs. open colectomy for cancer: comparison of short-term outcomes from 121 hospitals. J Gastrointest Surg. 2008;12(11):2001–9.

    PubMed  Google Scholar 

  61. Ghaferi AA, Birkmeyer JD, Dimick JB. Complications, failure to rescue, and mortality with major inpatient surgery in medicare patients. Ann Surg. 2009;250(6):1029–34.

    PubMed  Google Scholar 

  62. Copeland GP, Jones D, Walters M. POSSUM: a scoring system for surgical audit. Br J Surg. 1991;78(3):355–60.

    CAS  PubMed  Google Scholar 

  63. Knaus WA, et al. APACHE II: a severity of disease classification system. Crit Care Med. 1985;13(10):818–29.

    CAS  PubMed  Google Scholar 

  64. Bilimoria KY, et al. Development and evaluation of the universal ACS NSQIP surgical risk calculator: a decision aid and informed consent tool for patients and surgeons. J Am Coll Surg. 2013;217(5):833–42 e1–3.

    PubMed  PubMed Central  Google Scholar 

  65. Hornor MA, et al. Enhancing the American College of Surgeons NSQIP Surgical Risk Calculator to Predict Geriatric Outcomes. J Am Coll Surg. 2020;230(1):88–100. e1

    PubMed  Google Scholar 

  66. Lee MJ. Optimizing the safety of surgery, before surgery. Clin Orthop Relat Res. 2014;472(3):809–11.

    PubMed  Google Scholar 

  67. Scheede-Bergdahl C, Minnella EM, Carli F. Multi-modal prehabilitation: addressing the why, when, what, how, who and where next? Anaesthesia. 2019;74 Suppl 1:20–6.

    CAS  PubMed  Google Scholar 

  68. Carli F, et al. Effect of multimodal prehabilitation vs postoperative rehabilitation on 30-day postoperative complications for frail patients undergoing resection of colorectal cancer: a randomized clinical trial. JAMA Surg. 2020;155(3):233–42.

    PubMed  PubMed Central  Google Scholar 

  69. Artinyan A, et al. Prolonged postoperative ileus-definition, risk factors, and predictors after surgery. World J Surg. 2008;32(7):1495–500.

    PubMed  Google Scholar 

  70. Chudzinski AP, Thompson EV, Ayscue JM. Acute colonic pseudoobstruction. Clin Colon Rectal Surg. 2015;28(2):112–7.

    PubMed  PubMed Central  Google Scholar 

  71. Venara A, et al. Incidence and risk factors for severity of postoperative ileus after colorectal surgery: a prospective registry data analysis. World J Surg. 2019;

    Google Scholar 

  72. Goussous N, et al. Early postoperative small bowel obstruction: open vs laparoscopic. Am J Surg. 2015;209(2):385–90.

    PubMed  Google Scholar 

  73. Ellozy SH, et al. Early postoperative small-bowel obstruction: a prospective evaluation in 242 consecutive abdominal operations. Dis Colon Rectum. 2002;45(9):1214–7.

    PubMed  Google Scholar 

  74. Chu DI, et al. Early versus late adhesiolysis for adhesive-related intestinal obstruction: a nationwide analysis of inpatient outcomes. J Gastrointest Surg. 2013;17(2):288–97.

    PubMed  Google Scholar 

  75. Bauer J, et al. Adhesive small bowel obstruction: early operative versus observational management. Am Surg. 2015;81(6):614–20.

    PubMed  Google Scholar 

  76. Teixeira PG, et al. Early operation is associated with a survival benefit for patients with adhesive bowel obstruction. Ann Surg. 2013;258(3):459–65.

    PubMed  Google Scholar 

  77. Chen D, et al. Postoperative bleeding risk prediction for patients undergoing colorectal surgery. Surgery. 2018;164(6):1209–16.

    PubMed  Google Scholar 

  78. Hammond KL, Margolin DA. Surgical hemorrhage, damage control, and the abdominal compartment syndrome. Clin Colon Rectal Surg. 2006;19(4):188–94.

    PubMed  PubMed Central  Google Scholar 

  79. Hirshberg A, et al. Reoperation for bleeding in trauma. Arch Surg. 1993;128(10):1163–7.

    CAS  PubMed  Google Scholar 

  80. Kirkpatrick AW, et al. Intra-abdominal hypertension and the abdominal compartment syndrome: updated consensus definitions and clinical practice guidelines from the World Society of the Abdominal Compartment Syndrome. Intensive Care Med. 2013;39(7):1190–206.

    PubMed  PubMed Central  Google Scholar 

  81. De Waele JJ, Hoste EA, Malbrain ML. Decompressive laparotomy for abdominal compartment syndrome–a critical analysis. Crit Care. 2006;10(2):R51.

    PubMed  PubMed Central  Google Scholar 

  82. Emoto S, et al. Venous thromboembolism in colorectal surgery: incidence, risk factors, and prophylaxis. Asian J Surg. 2019;42(9):863–73.

    PubMed  Google Scholar 

  83. Gould MK, et al. Prevention of VTE in nonorthopedic surgical patients: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141(2 Suppl):e227S–77S.

    CAS  PubMed  PubMed Central  Google Scholar 

  84. Tenna AM, Kappadath S, Stansby G. Diagnostic tests and strategies in venous thromboembolism. Phlebology. 2012;27 Suppl 2:43–52.

    CAS  PubMed  Google Scholar 

  85. Anderson DJ, et al. Strategies to prevent surgical site infections in acute care hospitals: 2014 update. Infect Control Hosp Epidemiol. 2014;35 Suppl 2:S66–88.

    PubMed  Google Scholar 

  86. Zimlichman E, et al. Health care-associated infections: a meta-analysis of costs and financial impact on the US health care system. JAMA Intern Med. 2013;173(22):2039–46.

    PubMed  Google Scholar 

  87. Kirkland KB, et al. The impact of surgical-site infections in the 1990s: attributable mortality, excess length of hospitalization, and extra costs. Infect Control Hosp Epidemiol. 1999;20(11):725–30.

    CAS  PubMed  Google Scholar 

  88. Umscheid CA, et al. Estimating the proportion of healthcare-associated infections that are reasonably preventable and the related mortality and costs. Infect Control Hosp Epidemiol. 2011;32(2):101–14.

    PubMed  Google Scholar 

  89. Zywot A, et al. Bundles prevent surgical site infections after colorectal surgery: meta-analysis and systematic review. J Gastrointest Surg. 2017;21(11):1915–30.

    PubMed  Google Scholar 

  90. Allegranzi B, et al. New WHO recommendations on preoperative measures for surgical site infection prevention: an evidence-based global perspective. Lancet Infect Dis. 2016;16(12):e276–87.

    PubMed  Google Scholar 

  91. Allegranzi B, et al. New WHO recommendations on intraoperative and postoperative measures for surgical site infection prevention: an evidence-based global perspective. Lancet Infect Dis. 2016;16(12):e288–303.

    PubMed  Google Scholar 

  92. Ban KA, et al. American College of Surgeons and Surgical Infection Society: Surgical Site Infection Guidelines, 2016 Update. J Am Coll Surg. 2017;224(1):59–74.

    PubMed  Google Scholar 

  93. Berrios-Torres SI, et al. Centers for Disease Control and Prevention Guideline for the Prevention of Surgical Site Infection, 2017. JAMA Surg. 2017;152(8):784–91.

    PubMed  Google Scholar 

  94. Holubar SD, et al. American Society for Enhanced Recovery (ASER) and Perioperative Quality Initiative (POQI) joint consensus statement on prevention of postoperative infection within an enhanced recovery pathway for elective colorectal surgery. Perioper Med (Lond). 2017;6:4.

    PubMed  Google Scholar 

  95. Soderback H, et al. Incidence of wound dehiscence after colorectal cancer surgery: results from a national population-based register for colorectal cancer. Int J Color Dis. 2019;34(10):1757–62.

    Google Scholar 

  96. Deerenberg EB, et al. Small bites versus large bites for closure of abdominal midline incisions (STITCH): a double-blind, multicentre, randomised controlled trial. Lancet. 2015;386(10000):1254–60.

    PubMed  Google Scholar 

  97. Khorgami Z, et al. Prophylactic retention sutures in midline laparotomy in high-risk patients for wound dehiscence: a randomized controlled trial. J Surg Res. 2013;180(2):238–43.

    PubMed  Google Scholar 

  98. Sheka AC, Tevis S, Kennedy GD. Urinary tract infection after surgery for colorectal malignancy: risk factors and complications. Am J Surg. 2016;211(1):31–9.

    PubMed  Google Scholar 

  99. Southern WN, et al. Postoperative Clostridium difficile-associated diarrhea. Surgery. 2010;148(1):24–30.

    PubMed  Google Scholar 

  100. Zilberberg MD, Shorr AF, Kollef MH. Increase in adult Clostridium difficile-related hospitalizations and case-fatality rate, United States, 2000-2005. Emerg Infect Dis. 2008;14(6):929–31.

    PubMed  PubMed Central  Google Scholar 

  101. Jurt J, et al. Respiratory complications after colorectal surgery: avoidable or fate? World J Surg. 2018;42(9):2708–14.

    PubMed  Google Scholar 

  102. Nagle RT, et al. Pneumonia is associated with a high risk of mortality after pancreaticoduodenectomy. Surgery. 2017;161(4):959–67.

    PubMed  Google Scholar 

  103. McGillicuddy EA, et al. Factors predicting morbidity and mortality in emergency colorectal procedures in elderly patients. Arch Surg. 2009;144(12):1157–62.

    PubMed  Google Scholar 

  104. Chughtai M, et al. The incidence of postoperative pneumonia in various surgical subspecialties: a dual database analysis. Surg Technol Int. 2017;30:45–51.

    PubMed  Google Scholar 

  105. Sader HS, et al. Frequency and antimicrobial susceptibility of Gram-negative bacteria isolated from patients with pneumonia hospitalized in ICUs of US medical centres (2015–2017). J Antimicrob Chemother. 2018;73(11):3053–9.

    CAS  PubMed  Google Scholar 

  106. Damas P, et al. Prevention of ventilator-associated pneumonia and ventilator-associated conditions: a randomized controlled trial with subglottic secretion suctioning. Crit Care Med. 2015;43(1):22–30.

    PubMed  Google Scholar 

  107. Schwenk W, et al. Pulmonary function following laparoscopic or conventional colorectal resection: a randomized controlled evaluation. Arch Surg. 1999;134(1):6–12. discussion 13

    CAS  PubMed  Google Scholar 

  108. Milone M, et al. Pulmonary complications after surgery for rectal cancer in elderly patients: evaluation of laparoscopic versus open approach from a multicenter study on 477 consecutive cases. Gastroenterol Res Pract. 2017;2017:5893890.

    PubMed  PubMed Central  Google Scholar 

  109. Kozlow JH, et al. Epidemiology and impact of aspiration pneumonia in patients undergoing surgery in Maryland, 1999–2000. Crit Care Med. 2003;31(7):1930–7.

    PubMed  Google Scholar 

  110. Studer P, et al. Risk factors for fatal outcome in surgical patients with postoperative aspiration pneumonia. Int J Surg. 2016;27:21–5.

    PubMed  Google Scholar 

  111. Agnew NM, et al. Gastroesophageal reflux and tracheal aspiration in the thoracotomy position: should ranitidine premedication be routine? Anesth Analg. 2002;95(6):1645–9, table of contents.

    CAS  PubMed  Google Scholar 

  112. Starks B, Harbert C. Aspiration prevention protocol: decreasing postoperative pneumonia in heart surgery patients. Crit Care Nurse. 2011;31(5):38–45.

    PubMed  Google Scholar 

  113. Bihorac A. Acute kidney injury in the surgical patient: recognition and attribution. Nephron. 2015;131(2):118–22.

    PubMed  Google Scholar 

  114. Wiener JGD, et al. The Association of Enhanced Recovery Pathway and Acute Kidney Injury in Patients Undergoing Colorectal Surgery. Dis Colon Rectum. 2020;63(2):233–41.

    PubMed  Google Scholar 

  115. Poylin V, et al. Perioperative use of tamsulosin significantly decreases rates of urinary retention in men undergoing pelvic surgery. Int J Color Dis. 2015;30(9):1223–8.

    Google Scholar 

  116. Grass F, et al. Postoperative urinary retention in colorectal surgery within an enhanced recovery pathway. J Surg Res. 2017;207:70–6.

    PubMed  Google Scholar 

  117. Fleisher LA, et al. 2014 ACC/AHA guideline on perioperative cardiovascular evaluation and management of patients undergoing noncardiac surgery: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014;130(24):2215–45.

    PubMed  Google Scholar 

  118. Moghadamyeghaneh Z, et al. Risk factors of postoperative myocardial infarction after colorectal surgeries. Am Surg. 2015;81(4):358–64.

    PubMed  Google Scholar 

  119. Puelacher C, et al. Perioperative myocardial injury after noncardiac surgery: incidence, mortality, and characterization. Circulation. 2018;137(12):1221–32.

    PubMed  Google Scholar 

  120. Quinn R, et al. Morbidity and mortality with atrial fibrillation following colorectal surgery. ANZ J Surg. 2018;88(10):1003–7.

    PubMed  Google Scholar 

  121. Frendl G, et al. 2014 AATS guidelines for the prevention and management of perioperative atrial fibrillation and flutter for thoracic surgical procedures. J Thorac Cardiovasc Surg. 2014;148(3):e153–93.

    PubMed  PubMed Central  Google Scholar 

  122. Joshi KK, et al. Postoperative atrial fibrillation in patients undergoing non-cardiac non-thoracic surgery: a practical approach for the hospitalist. Hosp Pract (1995). 2015;43(4):235–44.

    PubMed  Google Scholar 

  123. Vlisides P, Mashour GA. Perioperative stroke. Can J Anaesth. 2016;63(2):193–204.

    PubMed  Google Scholar 

  124. Walsh PC, Schlegel PN. Radical pelvic surgery with preservation of sexual function. Ann Surg. 1988;208(4):391–400.

    CAS  PubMed  PubMed Central  Google Scholar 

  125. Adam JP, et al. Prospective and longitudinal study of urogenital dysfunction after proctectomy for rectal cancer. Dis Colon Rectum. 2016;59(9):822–30.

    PubMed  Google Scholar 

  126. Dulskas A, Samalavicius NE. A prospective study of sexual and urinary function before and after total mesorectal excision. Int J Color Dis. 2016;31(6):1125–30.

    Google Scholar 

  127. Eveno C, et al. Sexual and urinary dysfunction after proctectomy for rectal cancer. J Visc Surg. 2010;147(1):e21–30.

    CAS  PubMed  Google Scholar 

  128. Lindsey I, et al. Randomized, double-blind, placebo-controlled trial of sildenafil (Viagra) for erectile dysfunction after rectal excision for cancer and inflammatory bowel disease. Dis Colon Rectum. 2002;45(6):727–32.

    PubMed  Google Scholar 

  129. Waljee A, et al. Threefold increased risk of infertility: a meta-analysis of infertility after ileal pouch anal anastomosis in ulcerative colitis. Gut. 2006;55(11):1575–80.

    CAS  PubMed  PubMed Central  Google Scholar 

  130. Rajaratnam SG, et al. Impact of ileal pouch-anal anastomosis on female fertility: meta-analysis and systematic review. Int J Color Dis. 2011;26(11):1365–74.

    Google Scholar 

  131. Gorgun E, et al. Does laparoscopic ileal pouch-anal anastomosis reduce infertility compared with open approach? Surgery. 2019;166(4):670–7.

    PubMed  Google Scholar 

  132. Robinson TN, Eiseman B. Postoperative delirium in the elderly: diagnosis and management. Clin Interv Aging. 2008;3(2):351–5.

    PubMed  PubMed Central  Google Scholar 

  133. Kang SY, Seo SW, Kim JY. Comprehensive risk factor evaluation of postoperative delirium following major surgery: clinical data warehouse analysis. Neurol Sci. 2019;40(4):793–800.

    PubMed  Google Scholar 

  134. Raats JW, et al. Postoperative delirium in elderly after elective and acute colorectal surgery: a prospective cohort study. Int J Surg. 2015;18:216–9.

    CAS  PubMed  Google Scholar 

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Chu, D.I., Maron, D.J. (2022). General Postoperative Complications. In: Steele, S.R., Hull, T.L., Hyman, N., Maykel, J.A., Read, T.E., Whitlow, C.B. (eds) The ASCRS Textbook of Colon and Rectal Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-66049-9_8

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