Core outcome set for clinical studies of postoperative ileus after intestinal surgery

Chapman, Stephen J.; Lee, M J; Blackwell, Sue; Arnott, Robert; Broek, Richard P. G. ten; Delaney, Conor P.; Dudi-Venkata, NN; Fish, Rebecca; Hind, Daniel; Jayne, David; Mellor, Katie; Mishra, Anurag; O’Grady, Greg; Sammour, Tarik; Thorpe, Gabrielle; Wells, Cameron I.; Wolthuis, Albert; Fearnhead, Nicola; Adegbola, S; Bagaglini, Giulia; Bath, M F; Bibby, Neil; Bisset, Carly; Blefari, N; Blencowe, Natalie S; Bolton, William; Bulte, J.P.; Burch, Jale; Campanelli, Maurizio; Cano-Valderrama, Óscar; Carver, Julie; Challand, C; Chan, Shirley Chiu Wai; Chandler, S; Clerc, Daniel; Coe, Peter; Cox, Daniel; Cross, Karen L.; Culkin, Alison; Cuthill, Victoria; Daniels, Sarah; Dawson, Amanda; Dawson, Liza; Dixon, Frederick; Downey, Candice; Drake, Thomas M; Duff, Sarah; Dunning, G. C.; Espín‐Basany, Eloy; Evans, Martin D.D.; Fakhrul‐Aldeen, Mohammed; Fisher, Nigel; Fleetwood‐Beresford, Sahara; Gallo, G; Garoufalia, Zoe; George, R; Han, Jennie; Harji, Deena; Harmston, Rebecca; Harris, David A.; Mohammed, Mary F. Bucklin; Helliwell, Jack; Hepburn, J. W.; Herrod, Philip; Horwood, Natalie; Keane, Celia; Kelly, S. B.; Kroon, Hidde M.; Lonsdale, Maria dos Santos; Major, Giles; Mattison, J. R.; McLean, Andrew; Millán, Mónica; Limbert, S; McDermott, Frank; Mehraj, Asif; Moriarty, Christopher; Moug, Susan; Murray, Edward Croft; Naylor, Maureen; Nepogodiev, Dmitri; Oliver, James; Pandey, Deep Narayan; Pata, Francesco; Paterson, Hugh; Peckham‐Cooper, Adam; Pellino, Gianluca; Pockney, Peter; Proctor, Victoria; Proud, David; Rew, Vanessa; Rutegård, Martin; Sahnan, Kapil; Sayers, Adele; Siragusa, Leandro; Smillie, Robert; Spratt, John S.; Swain, David; Taylor, Sandy; Tejedor, Patricia; Thomas, Owen; THOMPSON, J. M.; Tsimogiannis, Konstantinos E; Tuohey, D; Vissapragada, Ravi; Younis, Mohammed U.; Vaughan-Shaw, P G; Whyte, Ken; Wheelband, Katharine R.; Williams, A; Yates, Adolph J.; Young, Rebekah

doi:10.1093/bjs/znac052

Cited by 9 publications

(2 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A recent multicentric prospective four-cohort study (laparoscopic extracorporeal and ICA; robotic extracorporeal and ICA) demonstrated lower overall complication rates after ICA, specifically less ileus, and PONV after robot-assisted procedures [ 33 ]. However, it is possible that differences in reporting postoperative ileus and differences in the definitions could make a comparison between studies difficult [ 35 , 36 ]. Furthermore, recent evidence suggested that the common assumption of postoperative paralysis might be incorrect and that the distal colon becomes hyperactive following surgery [ 37 ].…”

Section: Discussionmentioning

confidence: 99%

Gastrointestinal functions after laparoscopic right colectomy with intracorporeal anastomosis: a pilot randomized clinical trial on effects of abdominal drain, prolonged antibiotic prophylaxis, and D3 lymphadenectomy with complete mesocolic excision

Sica,

Siragusa,

Pirozzi

et al. 2024

Int J Colorectal Dis

View full text Add to dashboard Cite

Purpose Routine use of abdominal drain or prolonged antibiotic prophylaxis is no longer part of current clinical practice in colorectal surgery. Nevertheless, in patients undergoing laparoscopic right hemicolectomy with intracorporeal anastomosis (ICA), it may reduce perioperative abdominal contamination. Furthermore, in cancer patients, prolonged surgery with extensive dissection such as central vascular ligation and complete mesocolon excision with D3 lymphadenectomy (altogether radical right colectomy RRC) is called responsible for affecting postoperative ileus. The aim was to evaluate postoperative resumption of gastrointestinal functions in patients undergoing right hemicolectomy for cancer with ICA and standard D2 dissection or RRC, with or without abdominal drain and prolonged antibiotic prophylaxis. Methods Monocentric factorial parallel arm randomized pilot trial including all consecutive patients undergoing laparoscopic right hemicolectomy and ICA for cancer, in 20 months. Patients were randomized on a 1:1:1 ratio to receive abdominal drain, prolonged antibiotic prophylaxis or neither (I level), and 1:1 to receive RRC or D2 colectomy (II level). Patients were not blinded. The primary aim was the resumption of gastrointestinal functions (time to first gas and stool, time to tolerated fluids and food). Secondary aims were length of stay and complications’ rate. ClinicalTrials.gov no. NCT04977882. Results Fifty-seven patients were screened; according to sample size, 36 were randomized, 12 for each arm for postoperative management, and 18 for each arm according to surgical techniques. A difference in time to solid diet favored the group without drain or antibiotic independently from standard or RRC. Furthermore, when patients were divided with respect to surgical technique and into matched cohorts, no differences were seen for primary and secondary outcomes. Conclusion Abdominal drainage and prolonged antibiotic prophylaxis in patients undergoing right hemicolectomy for cancer with ICA seem to negatively affect the resumption of a solid diet after laparoscopic right hemicolectomy with ICA for cancer. RRC does not seem to influence gastrointestinal function recovery.

show abstract

Section: Discussionmentioning

confidence: 99%

Gastrointestinal functions after laparoscopic right colectomy with intracorporeal anastomosis: a pilot randomized clinical trial on effects of abdominal drain, prolonged antibiotic prophylaxis, and D3 lymphadenectomy with complete mesocolic excision

Sica,

Siragusa,

Pirozzi

et al. 2024

Int J Colorectal Dis

View full text Add to dashboard Cite

show abstract

“…The patients will stop chewing gum when POI resolves. Resolution of POI will be defined as passage of stool or flatus or both in addition to full filling the criteria defined in the 6 domains described by the Tripartite gastrointestinal recovery post-operative ileus group such as absence of nausea and vomiting, having no need of nasogastric intubation, absence of abdominal pain and distension, and ability to tolerate oral feeds [ 29 ]. Each patient will be offered a watch, notebook, and pen and with the help of the caretaker, record every day’s events and the time they occur.…”

Section: Methodsmentioning

confidence: 99%

Effect of Chewing Gum on Duration of Postoperative Ileus Following Laparotomy for Gastroduodenal Perforations: Protocol for a Randomized Controlled Trial

Muhumuza¹,

Molen²,

Mauricio³

et al. 2023

International Journal of Surgery Protocols

View full text Add to dashboard Cite

Background: Prolonged post-operative ileus is associated with increased risk of other complications, length of hospital stays and health care related costs. Chewing gum has been shown to reduce duration of ileus in many elective surgeries, but there is a paucity of randomised controlled trials (RCTs) on its effect on duration of ileus among patients undergoing emergency surgery, specifically patients with peritonitis. The aim of this study is to determine the effect of chewing gum on duration of postoperative ileus following laparotomy for gastroduodenal perforations.Methods: This will be a randomised controlled trial done in 3 hospitals. Fifty-two patients will be randomised to 2 groups. Group A will receive chewing gum in addition to routine care, whereas group B will receive routine care only. The duration of postoperative ileus in the two groups which is the primary outcome, will be compared using the independent samples t-test in SPSS version 22. The length of hospital stay, in-hospital morbidity and mortality will be the secondary outcomes. This trial has been approved by Kampala International University research and Ethics committee (Ref No. KIU-2021-60) and Uganda national council of science and technology (Ref No. HS1665ES). Retrospective registration with the research registry has also been done (UIN: researchregistry8565). Highlights• Prolonged post-operative ileus significantly contributes to adverse surgical outcomes• Chewing gum has been shown to reduce duration of ileus in many elective surgeries• There is paucity of RCTs on role of chewing gum following surgery for peritonitis

show abstract

A narrative on diversity, equity, and inclusion in surgery: insights from the European Society of Coloproctology and identification of points for action

Garoufalia,

Bellato,

Cunha

et al. 2024

Updates Surg

View full text Add to dashboard Cite

The focus of the 2022 European Society of Coloproctology (ESCP) annual campaign was diversity, equity, and inclusion (DEI) in surgery. The ESCP “Operation Equal Access” campaign sought to interview key-opinion leaders and trainees, to raise awareness on inequalities, inform the community of the status of the topic, and to identify future areas for improvement. The ESCP Social Media Working Group interviewed experts who have made significant contributions to DEI in colorectal surgery and were acknowledged opinion leaders in the field. The interviews focused on their career, professional life, experiences, and opportunities during their training, and their views on DEI in colorectal surgery. DEI principles, education, and values need further promotion to reduce and address bias within the profession and overall improve the experience of minority community including health professionals and patients. International Societies are working to facilitate training opportunities and overcome DEI, and networking have contributed to that. Collaborations between societies will be pivotal to contribute to offering research and leadership opportunities equally. Access to advanced workshops including cadaveric training and simulation can be consistently promoted and provided globally via societies through telemonitoring. Involving patients in research should be encouraged, as it brings the perspective of a living experience.

show abstract

Core outcome set for clinical studies of postoperative ileus after intestinal surgery

Cited by 9 publications

References 12 publications

Gastrointestinal functions after laparoscopic right colectomy with intracorporeal anastomosis: a pilot randomized clinical trial on effects of abdominal drain, prolonged antibiotic prophylaxis, and D3 lymphadenectomy with complete mesocolic excision

Gastrointestinal functions after laparoscopic right colectomy with intracorporeal anastomosis: a pilot randomized clinical trial on effects of abdominal drain, prolonged antibiotic prophylaxis, and D3 lymphadenectomy with complete mesocolic excision

Effect of Chewing Gum on Duration of Postoperative Ileus Following Laparotomy for Gastroduodenal Perforations: Protocol for a Randomized Controlled Trial

A narrative on diversity, equity, and inclusion in surgery: insights from the European Society of Coloproctology and identification of points for action

Contact Info

Product

Resources

About