Introduction:Postoperative ileus (POI) after laparoscopic colorectal surgery leads to increased anxiety for patients and caregivers, and is associated with prolonged hospital stay and increased costs. The aim of this study is to investigate pre-, intra- and postoperative risk factors associated with the development of POI in patients undergoing laparoscopic partial colectomy.Material and methods:Patients undergoing laparoscopic segmental colectomy from 2004-2008 were identified from a prospectively maintained laparoscopic database. Clinical, metabolic and pharmacologic data obtained retrospectively by reviewing the clinical charts. Patients with total colectomy or rectal resection were excluded. POI was defined as absence of bowel function for 5 or more days, or the need for reinsertion of a nasogastric tube after starting oral diet in the absence of mechanical obstruction. Factors associated with POI were analyzed using Chi-square or Fisher’s exact test for categorical variables, logistic regression for quantitative and ordinal variables. P-values <0.05 were considered statistically significant and Odds Ratios were calculated with a 95% confidence interval.Results: Of 425 patients (mean age 58 years, 52.9% female) undergoing segmental colectomy, 46 patients developed POI (10.8%). Patients who developed POI were significantly older (63.5 vs 57.2 years, P=0.0001, OR 1.23), more of them had previous abdominal surgery (65.2%vs. 48.9%, P= 0.03, OR 2.01), greater preoperative narcotic use (22.7%vs. 9.4% P=0.02, OR 2.84), more postoperative anastomotic leaks (8.7% vs. 1.9%, P=0.02, OR 5.06), more postoperative DVT (6.5% vs. 1.3%, P=0.045, OR 5.22), lower postoperative hemoglobin concentration (9.6 vs. 10.4 g/dL, P=0.006, OR 0.77), lower mean serum potassium level (3.4 vs. 3.7 mmol/L, P<0.001, OR 0.81), and lower mean calcium level (7.5 vs. 7.9 mmol/L, P=0.004, OR 0.92). ASA class, BMI, preoperative steroid use, operative time, estimated intraoperative blood loss, the use of a hand assisted technique or the occurrence of a postoperative abscess were not associated with POI.Conclusion:POI after laparoscopic segmental colectomy is associated with specific preoperative, intraoperative and postoperative factors. Minimizing or addressing these factors may be expected to reduce the incidence of this common complication.