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

doi:10.4251/wjgo.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

Retrospective Study

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.120582

Table 1 Comparison of clinical data and characteristics of bowel sounds on the first postoperative day among different groups of patients

Variables	Total (n = 133)	0 (n = 103)	1 (n = 30)	Statistic	P value
Age (year)	64.00 (56.00, 71.00)	64.00 (56.00, 70.00)	65.50 (61.25, 73.75)	Z = -0.81	0.419
Gender				χ² = 0.02	0.898
Male	74 (55.64)	57 (55.34)	17 (56.67)
Female	59 (44.36)	46 (44.66)	13 (43.33)
BMI (kg/m²)	23.18 (20.81, 24.91)	23.18 (20.90, 25.04)	22.75 (19.81, 24.38)	Z = -1.27	0.204
Diabetes mellitus				χ² = 0.74	0.391
No	111 (83.46)	88 (85.44)	23 (76.67)
Yes	22 (16.54)	15 (14.56)	7 (23.33)
Hypertension				χ² = 0.41	0.521
No	82 (61.65)	62 (60.19)	20 (66.67)
Yes	51 (38.35)	41 (39.81)	10 (33.33)
Coronary disease				χ² = 1.60	0.206
No	124 (93.23)	94 (91.26)	30 (100.00)
Yes	9 (6.77)	9 (8.74)	0 (0.00)
Smoking				χ² = 0.98	0.321
No	98 (73.68)	78 (75.73)	20 (66.67)
Yes	35 (26.32)	25 (24.27)	10 (33.33)
Drinking				χ² = 1.87	0.172
No	105 (78.95)	84 (81.55)	21 (70.00)
Yes	28 (21.05)	19 (18.45)	9 (30.00)
History of abdominal operation				χ² = 0.97	0.325
No	102 (76.69)	81 (78.64)	21 (70.00)
Yes	31 (23.31)	22 (21.36)	9 (30.00)
Accompanied by incomplete intestinal obstruction				χ² = 0.00	0.955
No	97 (72.93)	75 (72.82)	22 (73.33)
Yes	36 (27.07)	28 (27.18)	8 (26.67)
Stage cTNM				-	0.953
0	2 (1.50)	2 (1.94)	0 (0.00)
I	20 (15.04)	15 (14.56)	5 (16.67)
II	52 (39.10)	41 (39.81)	11 (36.67)
III	49 (36.84)	38 (36.89)	11 (36.67)
IV	10 (7.52)	7 (6.80)	3 (10.00)
Combined resection				χ² = 0.01	0.942
No	126 (94.74)	97 (94.17)	29 (96.67)
Yes	7 (5.26)	6 (5.83)	1 (3.33)
Surgical scope				χ² = 3.28	0.194
Right hemicolon	38 (28.57)	29 (28.16)	9 (30.00)
Left hemicolon	34 (25.56)	30 (29.13)	4 (13.33)
Rectum	61 (45.86)	44 (42.72)	17 (56.67)
Reinforced suture of the anastomosis				χ² = 1.74	0.188
No	57 (42.86)	41 (39.81)	16 (53.33)
Yes	76 (57.14)	62 (60.19)	14 (46.67)
Enterostomy				χ² = 1.51	0.219
No	100 (75.19)	80 (77.67)	20 (66.67)
Yes	33 (24.81)	23 (22.33)	10 (33.33)
Anemia				χ² = 0.16	0.690
No	77 (64.71)	58 (63.74)	19 (67.86)
Yes	42 (35.29)	33 (36.26)	9 (32.14)
Hypoproteinemia				χ² = 6.68	0.010
No	92 (69.17)	77 (74.76)	15 (50.00)
Yes	41 (30.83)	26 (25.24)	15 (50.00)
CEA				χ² = 0.85	0.357
Normal	79 (59.40)	59 (57.28)	20 (66.67)
Abnormal	54 (40.60)	44 (42.72)	10 (33.33)
CA19-9				χ² = 1.38	0.240
Abnormal	100 (75.19)	75 (72.82)	25 (83.33)
Normal	33 (24.81)	28 (27.18)	5 (16.67)
Potassium in blood				-	0.493
Hypokalemia	5 (4.20)	5 (5.49)	0 (0.00)
Normokalemia	113 (94.96)	85 (93.41)	28 (100.00)
Hyperkalemia	1 (0.84)	1 (1.10)	0 (0.00)
Operation time (minute)	235.00 (185.00, 300.00)	230.00 (165.00, 295.00)	272.50 (231.25, 365.00)	Z = -3.36	< 0.001
Anesthesia time (minute)	295.00 (225.00, 350.00)	295.00 (222.50, 350.00)	297.50 (232.50, 348.75)	Z = -0.76	0.446
NBS (cpm)				χ² = 13.54	< 0.001
≤ 1.201	36 (27.07)	20 (19.42)	16 (53.33)
> 1.201	97 (72.93)	83 (80.58)	14 (46.67)
RTBS (hour)				χ² = 10.88	< 0.001
≤ 16.90	47 (35.34)	44 (42.72)	3 (10.00)
> 16.90	86 (64.66)	59 (57.28)	27 (90.00)

Data were showed as n (%) or median (1^st quartile, 3^st quartile). Z means Mann-Whitney test; χ² means χ² test; - means Fisher exact. BMI: Body mass index; CEA: Carcinoembryonic antigen; CA19-9: Carbohydrate antigen 19-9; NBS: Number of bowel sounds; cpm: Counts per minute; RTBS: Recovery time of bowel sounds.

Full Size Table

Table 2 Analysis of bowel sounds characteristics before and after surgery in different groups of patients

Variables	Total (n = 133)	No-PPOI (n = 103)	PPOI (n = 30)	Z value¹	P value
Pre-operation 1 day NBS	7.05 (4.29, 9.59)	6.86 (4.28, 9.45)	7.62 (5.14, 9.86)	-0.82	0.415
Pre-operation 1 day BSVA	49.92 (47.66, 52.33)	50.08 (47.87, 52.37)	49.20 (47.09, 51.82)	-0.75	0.453
Pre-operation 1 day FBS	407.56 (351.78, 452.70)	415.95 (352.99, 452.76)	375.37 (321.35, 439.87)	-1.43	0.151
Operation day NBS	2.41 (1.30, 3.26)	2.38 (1.28, 3.23)	2.48 (1.58, 3.35)	-0.40	0.688
Operation day BSVA	43.44 (41.95, 45.71)	43.68 (42.12, 46.21)	42.77 (41.76, 44.60)	-1.46	0.145
Operation day FBS	399.59 (351.03, 461.91)	399.59 (350.22, 462.89)	399.53 (356.64, 451.15)	-0.37	0.712
RTBS	19.70 (15.00, 25.30)	18.10 (14.55, 24.95)	23.70 (18.23, 27.10)	-2.33	0.020
Post-operation 1 day NBS	2.46 (1.18, 3.61)	2.85 (1.42, 3.85)	1.19 (0.69, 2.53)	-3.81	<0.001
Post-operation 1 day BSVA	5.93 (3.42, 8.24)	6.16 (3.91, 8.39)	5.18 (3.05, 6.94)	-1.27	0.205
Post-operation 1 day FBS	406.38 (364.14, 451.16)	406.38 (363.79, 449.21)	403.31 (368.13, 460.78)	-0.57	0.566
Post-operation 2 day NBS	3.73 (2.26, 5.14)	3.79 (2.71, 5.15)	3.24 (1.38, 4.83)	-1.73	0.083
Post-operation 2 day BSVA	49.63 (47.85, 51.37)	49.93 (48.29, 51.53)	48.71 (46.50, 50.51)	-2.44	0.015
Post-operation 2 day FBS	411.17 (371.22, 456.93)	409.40 (363.93, 456.14)	413.56 (389.37, 462.64)	-1.40	0.162
Post-operation 3 days NBS	5.87 (3.60, 7.96)	5.81 (3.51, 8.02)	6.05 (4.43, 7.65)	-0.38	0.700
Post-operation 3 days BSVA	44.75 (42.23, 46.46)	44.75 (42.12, 46.47)	44.68 (42.53, 46.26)	-0.19	0.853
Post-operation 3 days FBS	381.25 (342.42, 448.98)	391.13 (345.84, 456.54)	361.53 (328.83, 424.37)	-1.56	0.118

¹Mann-Whitney test.

PPOI: Prolonged postoperative ileus; NBS: Number of bowel sounds; FBS: Frequency of bowel sounds; BSVA: Bowel sound vibration amplitude; RTBS: Recovery time of bowel sounds.

Full Size Table

Table 3 Multifactorial analysis of postoperative prolonged postoperative ileus occurrence

Variables	β	SE	Z value	P value	OR (95%CI)
NBS (> 1.201 cpm/≤ 1.201 cpm)	-1.03	0.50	-2.06	0.039	0.36 (0.13-0.95)
RTBS (> 16.90 hours/≤ 16.90 hours)	1.85	0.69	2.68	0.007	6.39 (1.65-24.73)
Operation time (> 205 minutes/≤ 205 minutes)	1.65	0.73	2.26	0.024	5.21 (1.25-21.74)
Hypoproteinemia (no/yes)	1.37	0.53	2.60	0.009	3.92 (1.40-10.98)

NBS: Number of bowel sounds; cpm: Counts per minute; RTBS: Recovery time of bowel sounds.

Full Size Table

Citation: Shi S, Wang C, Zhao CS, Chen Z, Yan L, Liang Y, Yue X, Duan XL, Wang ZZ. Clinical study predicting prolonged postoperative ileus after laparoscopic colorectal cancer surgery with intelligent bowel sound auscultation system. World J Gastrointest Oncol 2026; 18(7): 120582
URL: https://www.wjgnet.com/1948-5204/full/v18/i7/120582.htm
DOI: https://dx.doi.org/10.4251/wjgo.120582

Shi S, Wang C, Zhao CS, Chen Z, Yan L, Liang Y, Yue X, Duan XL, Wang ZZ. Clinical study predicting prolonged postoperative ileus after laparoscopic colorectal cancer surgery with intelligent bowel sound auscultation system. World J Gastrointest Oncol 2026; 18(7): 120582 [DOI: 10.4251/wjgo.120582]

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