Marco Ceresoli1, Federico Coccolini2, Fausto Catena3, Giulia Montori2, Salomone Di Saverio4, Massimo Sartelli5, Luca Ansaloni2. 1. General, Emergency and Trauma Surgery Department, Papa Giovanni XXIII Hospital, Piazza OMS 1, Bergamo 24127, Italy. Electronic address: marco.ceresoli89@gmail.com. 2. General, Emergency and Trauma Surgery Department, Papa Giovanni XXIII Hospital, Piazza OMS 1, Bergamo 24127, Italy. 3. General, Emergency and Trauma Surgery Department, Maggiore Hospital Regional Emergency Surgery and Trauma Center - Bologna Local Health District, Bologna, Italy. 4. Emergency Surgery Department, Parma University Hospital, Parma, Italy. 5. General Surgery Department, Macerata Hospital, Macerata, Italy.
Abstract
BACKGROUND: Adhesive small bowel obstructions are the most common postoperative causes of hospitalization. Several studies investigated the diagnostic and therapeutic role of water-soluble contrast agent (WSCA) in predicting the need for surgery, but there is no consensus. METHODS: A systematic review and meta-analysis was done of studies on diagnostic and therapeutic role of oral WSCA. RESULTS: WSCA had a sensitivity of 92% and a specificity of 93% in predicting resolution of obstruction without surgery; diagnostic accuracy increased significantly if abdominal X-rays were taken after 8 hours. The administration of oral WSCA reduced the need for surgery (odds ratio .55, P = .003), length of stay (weighted mean difference -2.18 days, P < .00001), and time to resolution (weighted mean difference -28.25 hours, P < .00001). No differences in terms of morbidity or mortality were recorded. CONCLUSIONS: The administration of WSCA is accurate in predicting the need for surgery; the test should be taken after at least 8 hours from administration. WSCA is a proven safe and effective treatment, correlated with a significant reduction in the need for surgery and in the length of hospital stay.
BACKGROUND: Adhesive small bowel obstructions are the most common postoperative causes of hospitalization. Several studies investigated the diagnostic and therapeutic role of water-soluble contrast agent (WSCA) in predicting the need for surgery, but there is no consensus. METHODS: A systematic review and meta-analysis was done of studies on diagnostic and therapeutic role of oral WSCA. RESULTS: WSCA had a sensitivity of 92% and a specificity of 93% in predicting resolution of obstruction without surgery; diagnostic accuracy increased significantly if abdominal X-rays were taken after 8 hours. The administration of oral WSCA reduced the need for surgery (odds ratio .55, P = .003), length of stay (weighted mean difference -2.18 days, P < .00001), and time to resolution (weighted mean difference -28.25 hours, P < .00001). No differences in terms of morbidity or mortality were recorded. CONCLUSIONS: The administration of WSCA is accurate in predicting the need for surgery; the test should be taken after at least 8 hours from administration. WSCA is a proven safe and effective treatment, correlated with a significant reduction in the need for surgery and in the length of hospital stay.
Authors: Adrian Diaz; Kevin B Ricci; Amy P Rushing; Angela M Ingraham; Vijaya T Daniel; Anghela Z Paredes; Holly E Baselice; Wendelyn M Oslock; Victor Heh; Scott A Strassels; Heena P Santry Journal: J Gastrointest Surg Date: 2020-02-10 Impact factor: 3.452
Authors: Yousef Amara; Ari Leppaniemi; Fausto Catena; Luca Ansaloni; Michael Sugrue; Gustavo P Fraga; Federico Coccolini; Walter L Biffl; Andrew B Peitzman; Yoram Kluger; Massimo Sartelli; Ernest E Moore; Salomone Di Saverio; Esfo Darwish; Chikako Endo; Harry van Goor; Richard P Ten Broek Journal: World J Emerg Surg Date: 2021-07-03 Impact factor: 5.469