Objective  To investigate the influencing factors of postoperative ileus (POI) complicated after laparoscopic surgery in patients with complicated acute appendicitis (CAA).

Methods  The clinical data of CAA patients attending Zhengzhou Central Hospital from September 2022 to December 2023 were retrospectively collected, and divided into the POI group and the non-POI group according to the postoperative clinical symptoms and imaging. Logistic regression was used to analyze the influencing factors of CAA complicating POI, and the predictive values of related factors were explored using the receiver operating characteristic (ROC) curve.

Results  153 CAA patients were included, with 15 in the POI group and 138 in the non-POI group. In the univariate analysis, the differences in age, history of abdominal surgery, preoperative systemic inflammatory response syndrome (SIRS), white blood cell (WBC), albumin (ALB), neutrophil/lymphocyte ratio (NLR), and postoperative indwelling drain between the POI group and the non-POI group were statistically significant (P<0.05). In the Logistic regression analysis, preoperative SIRS[OR=31.212, 95%CI(2.012, 484.090), P<0.05], elevated WBC[OR=1.328, 95%CI(1.048, 1.682), P<0.05] and elevated NLR[OR=1.430, 95%CI(1.114, 1.837), P<0.05] were risk factors for concomitant POI in CAA patients, and elevated ALB[OR=0.734, 95%CI(0.565, 0.953), P<0.05] was a protective factor for concomitant POI. In the ROC curve analysis, the areas under the curve of WBC, NLR, and ALB were 0.842[95%CI(0.756, 0.927), P<0.001)], 0.904[95%CI(0.831, 0.978), P<0.001], and 0.845[95%CI(0.734, 0.956), P<0.001], respectively.

Conclusion Preoperative complications with SIRS, high WBC, high NLR, and low ALB in CAA patients increase the risk of POI. WBC, NLR, and ALB have high predictive value for complications of POI in CAA patients.

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