Is colostomy closure without mechanical bowel preparation safe in pediatric patients? A randomized clinical trial

Fernandez-Portilla, Emilio; Dávila-Pérez, Roberto; Nieto-Zermeño, Jaime; Zalles-Vidal, Cristian; Vaamonde, Jorge Andrés Abello; Dominguez-Muñoz, Alfredo; López, Alfonso Reyes; Bracho-Blanchet, Eduardo

doi:10.1016/j.jpedsurg.2022.09.003

Cited by 2 publications

(13 citation statements)

References 33 publications

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“…A total of 3 studies 16,27,29 analysed data on anastomotic dehiscence and showed no statistical difference (OR 1.67, 95% CI: 0.13–22.20, p = 0.70, I 2 = 73%) (Figure 7). Additionally, intestinal obstruction 23,24,28,30 in patients could not demonstrate the advantages of MBP, incidence of intestinal obstruction (OR 1.95; 95% CI: 0.55–6.93, p = 0.30, I 2 = 0%) (Figure 8).…”

Section: Resultsmentioning

confidence: 96%

“…The search retrieved a total of 3960 studies, eliminating 1397 duplicates and 2548 studies that were not relevant to this study by reviewing the titles and abstracts. After reading the remaining 15 unique studies in detail, only 11 of them met the research criteria and contributed to the analysis 11,16,18,23–30 . The retrieval process diagram is shown in the Figure 1.…”

Section: Resultsmentioning

confidence: 99%

“…After reading the remaining 15 unique studies in detail, only 11 of them met the research criteria and contributed to the analysis. 11 , 16 , 18 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 The retrieval process diagram is shown in the Figure 1 .…”

Section: Resultsmentioning

confidence: 99%

“…Among the 1074 patients who used MBP in this study, the majority were under 10 years old. The patients were unable to understand the necessity of preoperative preparation, and their compliance and tolerance were relatively poor compared to adults, 37 which made it more difficult to take laxatives orally alone and often required administration through a nasogastric tube 24,30 . As is well known, drinking or administering laxatives through a nasogastric tube can be uncomfortable and stressful 38 .…”

Section: Discussionmentioning

confidence: 99%

“…Distribution characteristics of the selected studies used for meta-analysis. studies11,18,[23][24][25][26][27][28][29][30] reported surgical indications, including Anorectal malformation (n = 391), Hirschsprung's disease (n = 250), oesophageal atresia (n = 118), Caustic stricture (n = 43), Crohn's disease (n = 40), Spina bifida (n = 19); Ulcerative colitis (n = 18), Trauma (n = 16), Necrotizing enterocolitis (n = 14), and 61 other or unknown cases (including spina bifida with anorectal malformation, intestinal obstruction, Rectal perforation, Perforated appendicitis, and Familial adenomatous polyposis, etc.). Ares et al…”

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confidence: 99%

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The effect of preoperative mechanical bowel preparation in paediatric bowel surgery on postoperative wound related complications: A meta‐analysis

Chen,

Lin,

Miao

et al. 2024

International Wound Journal

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Mechanical bowel preparation (MBP), a routine nursing procedure before paediatric bowel surgery, is widely should in clinical practice, but its necessity remains controversial. In a systematic review and meta‐analysis, we evaluated the effect of preoperative MBP in paediatric bowel surgery on postoperative wound‐related complications in order to analyse the clinical application value of MBP in paediatric bowel surgery. As of November 2023, we searched four online databases: the Cochrane Library, Embase, PubMed, and Web of Science. Two investigators screened the collected studies against inclusion and exclusion criteria, and ROBINS‐I was used to evaluate the quality of studies. Using RevMan5.3, a meta‐analysis of the collected data was performed, and a fixed‐effect model or a random‐effect model was used to analyse OR, 95% CI, SMD, and MD. A total of 11 studies with 2556 patients were included. Most of studies had moderate‐to‐severe quality bias. The results of meta‐analysis showed no statistically significant difference in the incidence of complications related to postoperative infections in children with MBP before bowel surgery versus those with No MBP, wound infection (OR 1.11, 95% CI:0.76 ~ 1.61, p = 0.59, I2 = 5%), intra‐abdominal infection (OR 1.26, 95% CI:0.58 ~ 2.77, p = 0.56, I2 = 9%). There was no significant difference in the risk of postoperative bowel anastomotic leak (OR 1.07, 95% CI:0.68 ~ 1.68, p = 0.78, I2 = 12%), and anastomotic dehiscence (OR 1.67, 95% CI:0.13 ~ 22.20, p = 0.70, I2 = 73%). Patients' intestinal obstruction did not show an advantage of undergoing MBP preoperatively, with an incidence of intestinal obstruction (OR 1.95, 95% CI:0.55 ~ 6.93, p = 0.30, I2 = 0%). Based on existing evidence that preoperative MBP in paediatric bowel surgery did not reduce the risk of postoperative wound complications, we cautiously assume that MBP before surgery is unnecessary for children undergoing elective bowel surgery. However, due to the limited number of study participants selected for this study and the overall low quality of evidence, the results need to be interpreted with caution. It is suggested that more high quality, large‐sample, multicenter clinical trials are required to validate our findings.

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Section: Resultsmentioning

confidence: 96%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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The effect of preoperative mechanical bowel preparation in paediatric bowel surgery on postoperative wound related complications: A meta‐analysis

Chen,

Lin,

Miao

et al. 2024

International Wound Journal

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Evaluación en pacientes pediátricos del cierre de colostomía con sutura manual vs. sutura mecánica

Argotti Zumbana,

Salinas Salinas,

Acosta Farina

et al. 2023

REV-SEP

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Introducción: La colostomía es una alternativa de rescate en condiciones que impiden el normal movimiento del bolo fecal a través del recto y el ano. El objetivo del presente estudio fue evaluar el cierre de colostomía con sutura manual vs. sutura mecánica en pacientes pediátricos. Métodos: Este estudio observacional se realizó en el Hospital de Niños Dr. Roberto Gilbert Elizalde en Guayaquil, Ecuador. Se analizaron casos de cierre de colostomía con Sutura Manual versus Sutura mecánica desde el 2018 al 2023. Se compara el tiempo de hospitalización, complicaciones y necesidad de reintervención. Se comparan porcentajes con Chi cuadrado y tiempos con regresión de cox. Resultados: La muestra incluyó 76 pacientes, 56 con sutura manual y 20 con sutura mecánica. La necesidad de reintervención con ambas técnicas fue del 5 %, sin diferencia estadística. Tampoco existió diferencias entre el tiempo de permanencia hospitalaria. No hubo diferencias estadísticas entre el número de complicaciones presentadas entre los grupos de estudio, las cuales fueron un 12 % en el grupo de sutura manual y de un 25 % en el grupo de sutura mecánica. Regresión de cox con beneficio para la técnica mecánica. Conclusiones: Los hallazgos sugieren que ambas técnicas son similares en resultados postoperatorios tanto en hospitalización y complicaciones. Sin embargo, con menor reintervención en la técnica mecánica.

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Is colostomy closure without mechanical bowel preparation safe in pediatric patients? A randomized clinical trial

Cited by 2 publications

References 33 publications

The effect of preoperative mechanical bowel preparation in paediatric bowel surgery on postoperative wound related complications: A meta‐analysis

The effect of preoperative mechanical bowel preparation in paediatric bowel surgery on postoperative wound related complications: A meta‐analysis

Evaluación en pacientes pediátricos del cierre de colostomía con sutura manual vs. sutura mecánica

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