{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T15:07:47Z","timestamp":1787670467474,"version":"build-2736575974"},"reference-count":37,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:00:00Z","timestamp":1785801600000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) is standard treatment for peritoneal metastases in Sweden. Prolonged postoperative ileus (PPOI) is a common complication following major abdominal surgery and is associated with increased morbidity and prolonged hospitalization. The aim of this study was to evaluate the incidence of PPOI following CRS\u2010HIPEC and to identify factors associated with its development, including its relationship to postoperative complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective, bicentre cohort study included patients undergoing CRS\u2010HIPEC for peritoneal metastases between January 2012 and 2024. Patients were identified through the Swedish HIPEC Registry, with supplementary data obtained from medical records. PPOI was defined as delayed defaecation beyond postoperative day 5 and\/or prolonged use or reinsertion of a nasogastric tube. Clinical, surgical and postoperative outcomes were analysed and risk factors for PPOI were assessed using a multivariable logistic regression model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 982 patients were included, of whom 443 (45%) developed PPOI. Patients with PPOI had significantly longer hospital stays (median 11 vs. 9;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and delayed return of bowel function compared with patients without PPOI (median 6 vs. 3\u2009days;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Major complications were more frequently observed in patients with PPOI (36% vs. 16%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Independent risk factors for PPOI were major postoperative complications (aOR 3.74, CI 2.55\u20135.48), blood transfusion (aOR 1.70, CI 1.08\u20132.70) and omentectomy below the gastroepiploic arcade (aOR 1.51, CI 1.01\u20132.26). This association remained even after excluding patients with major postoperative surgical complications. Ileostomy formation was associated with a reduced risk of PPOI (aOR 0.51, CI 0.33\u20130.77).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>PPOI is a frequent complication following CRS\u2010HIPEC and is associated with increased postoperative morbidity and prolonged recovery. Strategies aimed to optimize perioperative care and enhanced recovery protocols may help to reduce the incidence and the adverse effects of PPOI.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/codi.70567","type":"journal-article","created":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T04:51:02Z","timestamp":1785905462000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Incidence and outcomes of postoperative paralytic ileus after cytoreductive surgery with\n                    <scp>HIPEC<\/scp>\n                    : A population\u2010based study"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6513-8228","authenticated-orcid":false,"given":"Lana","family":"Ghanipour","sequence":"first","affiliation":[{"name":"Department of Surgical Sciences Uppsala University  Uppsala Sweden"},{"name":"Department of Surgery Uppsala University Hospital  Uppsala 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Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3474-9450","authenticated-orcid":false,"given":"Peter","family":"Cashin","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences Uppsala University  Uppsala Sweden"},{"name":"Department of Surgery Uppsala University Hospital  Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6538-7301","authenticated-orcid":false,"given":"Mirna","family":"Abraham\u2010Nordling","sequence":"additional","affiliation":[{"name":"Department of Pelvic Cancer, Division of Coloproctology, Center for Digestive Diseases Karolinska University Hospital  Stockholm Sweden"},{"name":"Department of Molecular Medicine and Surgery Karolinska Institutet  Stockholm 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