A M Wolthuis1, G Bislenghi1, S Fieuws2, A de Buck van Overstraeten1, G Boeckxstaens3, A D'Hoore1. 1. Department of Abdominal Surgery, University Hospital Leuven, Leuven, Belgium. 2. KU Leuven - University of Leuven and Universiteit Hasselt, Interuniversity Center for Biostatistics and Statistical Bioinformatics, Leuven, Belgium. 3. KU Leuven - Translational Research Center for Gastrointestinal Disorders (TARGID), University Hospital Leuven, Leuven, Belgium.
Abstract
AIM: Prolonged postoperative ileus (PPOI) after colorectal surgery remains a leading cause of delayed postoperative recovery and prolonged hospital stay. Its exact incidence is unknown. The aim of this systematic review is to investigate the definitions and incidence of PPOI previously described. METHOD: MEDLINE, Embase and the Cochrane Database of Systematic Reviews (up to July 2014) were searched. Two authors independently reviewed citations using predefined inclusion and exclusion criteria. RESULTS: The search strategy yielded 3233 citations; 54 were eligible, comprising 18 983 patients. Twenty-six studies were prospective [17 of these being randomized controlled trials (RCTs)] and 28 were retrospective. Meta-analysis revealed an incidence of PPOI of 10.3% (95% CI 8.4-12.5) and 10.2% (95% CI 5.6-17.8) for non-RCTs and RCTs, respectively. Significant heterogeneity was observed for both non-RCTs and for RCTs. The used definition of PPOI, the type of surgery and access (laparoscopic, open) and the duration of surgery lead to significant variability of reported PPOI incidence between studies. The incidence of PPOI is lower after laparoscopic colonic resection. CONCLUSION: There is a large variation in the reported incidence of PPOI. A uniform definition of PPOI is needed to allow meaningful inter-study comparisons and to evaluate strategies to prevent PPOI. Colorectal Disease
AIM: Prolonged postoperative ileus (PPOI) after colorectal surgery remains a leading cause of delayed postoperative recovery and prolonged hospital stay. Its exact incidence is unknown. The aim of this systematic review is to investigate the definitions and incidence of PPOI previously described. METHOD: MEDLINE, Embase and the Cochrane Database of Systematic Reviews (up to July 2014) were searched. Two authors independently reviewed citations using predefined inclusion and exclusion criteria. RESULTS: The search strategy yielded 3233 citations; 54 were eligible, comprising 18 983 patients. Twenty-six studies were prospective [17 of these being randomized controlled trials (RCTs)] and 28 were retrospective. Meta-analysis revealed an incidence of PPOI of 10.3% (95% CI 8.4-12.5) and 10.2% (95% CI 5.6-17.8) for non-RCTs and RCTs, respectively. Significant heterogeneity was observed for both non-RCTs and for RCTs. The used definition of PPOI, the type of surgery and access (laparoscopic, open) and the duration of surgery lead to significant variability of reported PPOI incidence between studies. The incidence of PPOI is lower after laparoscopic colonic resection. CONCLUSION: There is a large variation in the reported incidence of PPOI. A uniform definition of PPOI is needed to allow meaningful inter-study comparisons and to evaluate strategies to prevent PPOI. Colorectal Disease
Authors: Nourah Alsharqawi; Mohsen Alhashemi; Pepa Kaneva; Gabriele Baldini; Julio F Fiore; Liane S Feldman; Lawrence Lee Journal: Surg Endosc Date: 2019-07-30 Impact factor: 4.584
Authors: R Vather; G O'Grady; A Y Lin; P Du; C I Wells; D Rowbotham; J Arkwright; L K Cheng; P G Dinning; I P Bissett Journal: Br J Surg Date: 2018-04-14 Impact factor: 6.939
Authors: Albert M Wolthuis; Gabriele Bislenghi; Maarten Lambrecht; Steffen Fieuws; Anthony de Buck van Overstraeten; Guy Boeckxstaens; André D'Hoore Journal: Int J Colorectal Dis Date: 2017-04-25 Impact factor: 2.571