Bowel function recovery after laparoscopic transverse colectomy within an ERAS program: a comparison to right and left colectomy

Roesel, Raffaello; Mongelli, Francesco; Ajani, Costanza; Iaquinandi, Fabiano; Celio, Diana; Christoforidis, Dimitri

doi:10.1007/s00423-021-02082-3

Cited by 5 publications

(10 citation statements)

References 24 publications

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“…The database search identified 1934 results. Following duplicate removal, title and abstract screening and full text assessment, nine studies were identified for inclusion [8,[25][26][27][28][29][30][31][32] (Figure 1). Three studies included overlapping databases and study periods [8,33,34]; only the study with the longest period of data capture was included in the present meta-analysis to prevent multiple publication bias [8].…”

Section: Search Resultsmentioning

confidence: 99%

“…Time to first flatus (MD +0.23, 95% CI −0.41-0.87 days; P = 0.48; 5) and stool (MD +0.16, 95% CI −0.23-0.55 days; P = 0.42; I 2 = 13%; Table 5) did not differ between right-sided and left-sided colectomy cohorts [28,31]. Notably, one of these studies was at critical risk of bias [28].…”

Section: Time To First Passage Of Flatus Stoolmentioning

confidence: 95%

“…Enhanced recovery after surgery protocol definitions were provided in five studies [25,27,29,31,32], and it was not clear whether an ERAS protocol was used in the remaining studies. Details of these protocols are provided in Table S3; protocols were heterogeneously defined, and no studies employed identical definitions.…”

Section: Institution Eras Practicesmentioning

confidence: 99%

“…Anastomotic configurations following right-and left-sided colectomy in each study are provided in Table S7. Four studies reported on their anastomotic configurations [25][26][27]31]: extracorporeal, handsewn anastomoses were employed in all right-sided colectomies, whereas in left-sided colectomies an intracorporeal and double-stapled anastomosis was most commonly used.…”

Section: Anastomotic Techniquesmentioning

confidence: 99%

“…Two studies including 226 colectomies (115 right-sided; 111 leftsided) reported time to first passage of flatus and stool [28,31].…”

Section: Time To First Passage Of Flatus Stoolmentioning

confidence: 99%

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Prolonged postoperative ileus following right‐ versus left‐sided colectomy: A systematic review and meta‐analysis

et al. 2021

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Aim: Prolonged postoperative ileus (PPOI) is a common complication following colonic surgery, and is associated with longer hospital stay, greater risk of complications and substantial cost for patients and hospitals. Some reports have recently suggested that gastrointestinal (GI) recovery varies based on the side of resection (i.e., right-sided vs. left-sided colectomy). This systematic review and meta-analysis aimed to compare GI recovery by resection side. Methods:The MEDLINE, Embase, Cochrane Library and CENTRAL databases were systematically searched for articles reporting GI recovery outcomes in adults undergoing elective right-versus left-sided colectomy (excluding with ileostomy) of any surgical approach. The primary outcome was PPOI, and secondary outcomes included time to first passage of flatus, stool and tolerance of solid diet, and postoperative complications.Subgroup analyses of laparoscopic procedures and cohorts without inflammatory bowel disease and sensitivity analysis of adjusted multivariate results were also performed.Results: Nine studies were identified, of which seven were included in the meta-analysis, comprising 29 068 colectomies (14 581 right-sided; 14 487 left-sided). PPOI was heterogeneously defined and was significantly more likely following right-sided compared to left-sided colectomy regardless of the surgical approach (OR 1.78, 95% CI 1.32-2.39; P < 0.01; I 2 = 51%), as well as on subgroup analyses and adjusted multivariate metaanalysis. Secondary outcomes were reported in only a few small studies; hence metaanalysis did not produce reliable results. Conclusion:Based on heterogeneous definitions, consistently higher rates of PPOI were observed following right-versus left-sided colectomy. These differences are currently unexplained and highlight the need for further research into the pathophysiology of ileus.

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