Analysis of the predictive value of age and serum IL-6 level at 24-hour postoperatively for prolonged postoperative ileus after laparoscopic colorectal cancer surgery.

BACKGROUND

Prolonged postoperative ileus (PPOI) is a common complication following laparoscopic colorectal cancer surgery, which is closely associated with systemic inflammatory responses triggered by surgical trauma.

OBJECTIVE

This study aimed to investigate the relationships between age, serum IL-6 levels at 24 h postoperatively, and PPOI following laparoscopic radical resection for colorectal cancer and to evaluate their indicative value for PPOI.

METHODS

From March to November 2025, 106 patients who were diagnosed with colorectal cancer preoperatively were prospectively enrolled. After screening, 76 cases were ultimately included. Univariate and multivariate logistic regression analyses identified independent risk factors, and receiver operating characteristic curves clarified the predictive value of relevant indicators for PPOI.Finally, an internal validation was conducted using Bootstrap.

RESULTS

The incidence of PPOI was 26.32%. After univariate and multivariate analyses were performed, age and postoperative 24-hour serum IL-6 concentration were identified as independent risk factors for PPOI. Combined analysis based on these independent risk factors yielded an area under the receiver operating characteristic curve (AUROC) of 0.822 (95% CI: 0.712–0.932).After 1000 bootstrap internal validation corrections, the AUROC of the model was 0.830 .Statistical analysis identified patients aged ≥ 65 years and with a postoperative 24-hour serum IL-6 concentration ≥ 109 pg/mL had a significantly increased incidence of PPOI.

CONCLUSION

The ROC curve analysis demonstrated that patients aged ≥ 65 years and those with postoperative 24 h serum IL-6 ≥ 109 pg/mL were defined as high risk cases. These findings can guide clinicians to implement intensive monitoring and individualized intervention for such high risk postoperative patients. Meanwhile, these findings may inform future large-scale, multicenter prospective studies. TRIAL REGISTRATION: Registration Unit: China Clinical Trial Registry Registration number: ChiCTR2500096778.Register website: https://www.chictr.org.cn/secsponsorproj.html registration date༚2025-02-06