Randomized controlled trial of Gastrografin in adhesive small bowel obstruction

Burge, Jonathan; Abbas, Saleh; Roadley, Graeme; Donald, J. J.; Connolly, Andrew B.; Bissett, Ian P.; Hill, Andrew G.

doi:10.1111/j.1445-2197.2005.03491.x

Cited by 76 publications

(74 citation statements)

References 6 publications

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“…Studies that examined the therapeutic role of Gastrografin  randomized patients to 100 ml Gastrografin  or placebo, orally or via a nasogastric tube, which was then clamped for 60 min. Patients were otherwise treated similarly 5,11,15,18,22,23 .…”

Section: Characteristics Of Selected Studiesmentioning

confidence: 99%

“…Of the studies that addressed the therapeutic role of Gastrografin  , that by Burge et al 22 scored the maximum 5 points on the Jadad scale. It was double blinded, and concealment method and dropouts were described.…”

Section: Quality Of Included Studiesmentioning

confidence: 99%

“…The decision to operate was made on clinical grounds of failure of the obstruction to resolve or the onset of signs of strangulation. Although this was independent of the initial radiology, further radiography was performed to assess ongoing obstruction except in one study 22 . The radiography results may have influenced the decision to operate in the study of Biondo and colleagues 18 as patients who needed surgery in the Gastrografin  group underwent operation significantly earlier.…”

Section: Quality Of Included Studiesmentioning

confidence: 99%

“…All six studies addressed this question 5,11,15,18,22,23 . There was no significant difference between Gastrografin  and placebo in the rate of resolution of small bowel obstruction without surgery (OR 0·81 (95 per cent c.i.…”

Section: Resolution Of Obstruction or Surgerymentioning

confidence: 99%

“…Four studies 11,18,22,23 reported the mean(s.d.) length of hospital stay in patients who did not require surgery.…”

Section: Hospital Staymentioning

confidence: 99%

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Meta-analysis of oral water-soluble contrast agent in the management of adhesive small bowel obstruction

Abbas

Bissett

Parry

2007

British Journal of Surgery

101

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Background: Adhesions are the leading cause of small bowel obstruction. Identification of patients who require surgery is difficult. This review analyses the role of Gastrografin  as a diagnostic and therapeutic agent in the management of adhesive small bowel obstruction.Methods: A systematic search of Medline, Embase and Cochrane databases was performed to identify studies of the use of Gastrografin  in adhesive small bowel obstruction. Studies that addressed the diagnostic role of water-soluble contrast agent were appraised, and data presented as sensitivity, specificity, and positive and negative likelihood ratios. Results were pooled and a summary receiver-operator characteristic (ROC) curve was constructed. A meta-analysis of the data from six therapeutic studies was performed using the Mantel-Haenszel test and both fixed-and random-effect models.Results: The appearance of water-soluble contrast agent in the colon on an abdominal radiograph within 24 h of its administration predicted resolution of obstruction with a pooled sensitivity of 97 per cent and specificity of 96 per cent. The area under the summary ROC curve was 0·98. Water-soluble contrast agent did not reduce the need for surgical intervention (odds ratio 0·81, P = 0·300), but it did reduce the length of hospital stay for patients who did not require surgery compared with placebo (weighted mean difference −1·84 days; P < 0·001). Conclusion:Published data strongly support the use of water-soluble contrast medium as a predictive test for non-operative resolution of adhesive small bowel obstruction. Although Gastrografin  does not reduce the need for operation, it appears to shorten the hospital stay for those who do not require surgery.

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Section: Characteristics Of Selected Studiesmentioning

confidence: 99%

Section: Quality Of Included Studiesmentioning

confidence: 99%

Section: Quality Of Included Studiesmentioning

confidence: 99%

Section: Resolution Of Obstruction or Surgerymentioning

confidence: 99%

“…Four studies 11,18,22,23 reported the mean(s.d.) length of hospital stay in patients who did not require surgery.…”

Section: Hospital Staymentioning

confidence: 99%

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Meta-analysis of oral water-soluble contrast agent in the management of adhesive small bowel obstruction

Abbas

Bissett

Parry

2007

British Journal of Surgery

101

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Oral water soluble contrast for the management of adhesive small bowel obstruction

Abbas

Bissett

Parry³

2007

Cochrane Database of Systematic Reviews

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Gastrografin reduces the need for additional surgery in postoperative small bowel obstruction patients without long tube insertion: A meta‐analysis

Ishizuka

Shibuya

Takagi

et al. 2018

Annals of Gastroent Surgery

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Background Small bowel obstruction (SBO) is a well‐known major postoperative complication requiring immediate diagnosis and treatment to avoid additional invasive surgical procedures. Water‐soluble contrast medium is often given not only for diagnosis but also for treatment. Although numerous studies have investigated the significance of this treatment, no consensus has yet been established regarding its indications and efficacy. Objective To explore whether Gastrografin can reduce the need for additional surgery in patients with postoperative SBO (PSBO). Methods We carried out a comprehensive electronic search of the literature (Cochrane Library, MEDLINE, PubMed and the Web of Science) up to February 2017 to identify studies that had shown efficacy of Gastrografin in reducing the need for surgery in patients with PSBO. To integrate the individual effects of Gastrografin, a meta‐analysis was done using random‐effects models to calculate the risk ratio (RR) and 95% confidence interval (CI), and heterogeneity was analyzed using I2 statistics. Results Twelve studies involving a total of 1153 patients diagnosed as having PSBO were included in this meta‐analysis. Not all patients received long‐tube insertion. Among 580 patients who received Gastrografin, 100 (17.2%) underwent surgery, whereas among 573 patients who did not receive Gastrografin, 143 (25.0%) underwent surgery. Giving Gastrografin significantly reduced the need for surgery (RR, 0.66; 95% CI, 0.46‐0.95; P = 0.02; I2 = 52%) in comparison with patients who did not receive Gastrografin. Conclusion Results of this meta‐analysis show that giving Gastrografin reduces the need for surgery in PSBO patients without long‐tube insertion.

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Randomized controlled trial of Gastrografin in adhesive small bowel obstruction

Abstract: Gastrografin accelerates resolution of ASBO by a specific therapeutic effect.

Cited by 76 publications

References 6 publications

Meta-analysis of oral water-soluble contrast agent in the management of adhesive small bowel obstruction

Meta-analysis of oral water-soluble contrast agent in the management of adhesive small bowel obstruction

Oral water soluble contrast for the management of adhesive small bowel obstruction

Gastrografin reduces the need for additional surgery in postoperative small bowel obstruction patients without long tube insertion: A meta‐analysis

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