Clinical study predicting prolonged postoperative ileus after laparoscopic colorectal cancer surgery with intelligent bowel sound auscultation system

doi:10.4251/wjgo.v18.i7.120582

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World Journal of Gastrointestinal Oncology

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1948-5204

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastrointest Oncol. Jul 15, 2026; 18(7): 120582
Published online Jul 15, 2026. doi: 10.4251/wjgo.v18.i7.120582

Clinical study predicting prolonged postoperative ileus after laparoscopic colorectal cancer surgery with intelligent bowel sound auscultation system

Shuai Shi, Chong Wang, Chen-Si Zhao, Zun Chen, Liang Yan, Yong Liang, Xin Yue, Xiang-Long Duan, Zuo-Zheng Wang

Shuai Shi, Chen-Si Zhao, The First Clinical Medical College, Ningxia Medical University, Yinchuan 750003, Ningxia Hui Autonomous Region, China

Shuai Shi, Chen-Si Zhao, Zuo-Zheng Wang, Department of Hepatobiliary Surgery, Ningxia Medical University’s General Hospital, Yinchuan 750004, Ningxia Hui Autonomous Region, China

Shuai Shi, Chong Wang, Zun Chen, Xin Yue, Xiang-Long Duan, Department of General Surgery II, Shaanxi Provincial People’s Hospital, Xi’an 710068, Shaanxi Province, China

Shuai Shi, Chong Wang, Zun Chen, Xin Yue, Xiang-Long Duan, Shaanxi Engineering Research Center of Medical Polymer Materials, Shaanxi Provincial People’s Hospital, Xi’an 710068, Shaanxi Province, China

Liang Yan, Institute of Navigation, Northwestern Polytechnical University, Xi’an 710072, Shaanxi Province, China

Yong Liang, Department of Electronics and Information Engineering, Xi’an Polytechnic University, Xi’an 710048, Shaanxi Province, China

Xiang-Long Duan, Shaanxi International Science and Technology Cooperation Base for Clinical Medicine, Shaanxi Provincial People’s Hospital, Xi’an 710068, Shaanxi Province, China

Xiang-Long Duan, School of Life Science and Technology, Northwestern Polytechnical University, Xi’an 710072, Shaanxi Province, China

Xiang-Long Duan, School of Medicine, Xizang Minzu University, Xianyang 712082, Shaanxi Province, China

Co-corresponding authors: Xiang-Long Duan and Zuo-Zheng Wang.

Author contributions: Duan XL and Wang ZZ were responsible for study design and data analysis and they contribute equally to this study as co-corresponding authors; Shi S was responsible for data collection, analysis, study design, and writing; Yan L and Liang Y were responsible for bowel sound analysis and study design; Wang C, Chen Z, Zhao CS, and Yue X were responsible for data collection and analysis.

Supported by National Natural Science Foundation of China, No. 82460107; Innovation Capability Support Program of Shaanxi, No. 2024GH-GHJD-21; Science and Technology Talent Support Program of Shaanxi Provincial People’s Hospital, No. 2021 LJ-05; Science and Technology Program of Xi’an, No. 2024JH-ZCLGG-0004; Yinchuan City Science and Technology Support Project, No. 2024SF043; Ningxia Hui Autonomous Region Central Guidance Local Science and Technology Development Special Project, No. 2023FRD05009.

Institutional review board statement: The study was conducted in accordance with the Declaration of Helsinki, and approved by the Medical Ethics Committee of Shaanxi Provincial People’s Hospital.

Informed consent statement: Informed consent was obtained from all subjects involved in the study.

Conflict-of-interest statement: The authors declare no conflicts of interest.

Data sharing statement: The data supporting the findings of this study are available from the corresponding author upon request.

Corresponding author: Xiang-Long Duan, Department of General Surgery II, Shaanxi Provincial People’s Hospital, No. 256 Youyi East Road, Xi’an 710068, Shaanxi Province, China. duanxl390@126.com

Received: March 3, 2026
Revised: March 10, 2026
Accepted: March 31, 2026
Published online: July 15, 2026
Processing time: 127 Days and 6 Hours

Abstract

BACKGROUND

The study of prolonged postoperative ileus (PPOI) after laparoscopic colorectal cancer (CRC) surgery is a clinically significant concern, but there is little research on predicting gastrointestinal function of CRC patients through the characteristics of bowel sounds.

AIM

To analyze differences in bowel sound characteristics in patients with PPOI after surgery, and aims to establish a predictive model to provide clinicians with a new method for evaluating postoperative gastrointestinal function.

METHODS

A retrospective analysis was conducted on 133 patients diagnosed with CRC who underwent surgical treatment in the Department of General Surgery II of Shaanxi Provincial People’s Hospital from January 2022 to January 2024. This study analyzes the characteristics of bowel sounds in PPOI patient pre-operation 1 day, on operation day, and post-operation 3 days, clarifying their differences and trends. The Mann-Whitney U test, Kolmogorov-Smirnov test, and receiver operating characteristic (ROC) curve analysis were used to examine the relationship between clinical indicators and bowel sound characteristics with postoperative PPOI. Univariate and multifactorial analyses were performed to clarify the differences between the PPOI and no-PPOI groups. Subsequently, significant variables were selected and incorporated into the model for further modeling.

RESULTS

The analysis found that patients with PPOI had significant differences in number of bowel sounds (NBS) and recovery time of bowel sounds (RTBS) on the post-operation 1 day. The characteristics of bowel sounds predicted the occurrence of postoperative PPOI with certain predictive value according to the ROC curve. The NBS cutoff value was 1.201 counts per minute, with a sensitivity of 56.67% and specificity of 80.58%. The RTBS cutoff value was 16.9 hours, with a sensitivity of 90.00% and specificity of 43.75%. Univariate analysis revealed significant differences in operation time, preoperative hypoproteinemia, RTBS, and NBS between the PPOI group and the no-PPOI group. The LASSO regression and the Boruta algorithm were used in conjunction with univariate and multivariate logistic regression to screen for relevant variables, ultimately including four variables in the model: Operation time, preoperative hypoproteinemia, RTBS, and NBS. Decision curve analysis indicated that the risk nomogram for PPOI after CRC surgery provides a good clinical net benefit.

CONCLUSION

The characteristics of bowel sounds have certain predictive value for PPOI after laparoscopic CRC surgery. The intelligent auscultation system collects bowel sounds, which helps establish a predictive model for the occurrence of PPOI. It provides objective reference indicators for its early detection and warrants further investigation.

Keywords: Colorectal cancer; Bowel sounds; Prolonged postoperative ileus; Predict model

Core Tip: This study constitutes the first application of an intelligent auscultation system for extended monitoring of gastrointestinal function in colorectal cancer patients following surgery, enabling prediction of gastrointestinal functional outcomes through acoustic feature analysis.