Role of Mechanical Bowel Preparation and Perioperative Antibiotics in Pediatric Pull-Through Procedures

Carpenter, Kyle L.; Breckler, Francine D.; Gray, Brian W.

doi:10.1016/j.jss.2019.03.051

Cited by 4 publications

(2 citation statements)

References 16 publications

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“…The authors found that such interventions decreased the incidence of postoperative constipation to 50.8%. Although high-quality randomized controlled studies are currently lacking in pediatric enhanced recovery after surgery, routine preoperative mechanical bowel preparation is not recommended for the prevention of constipation (28)(29)(30)(31). Therefore, patients should ensure sufficient dietary fiber and fluid intake and avoid foods to which they are intolerant (decreased consumption of fructose and lactose) during the perioperative period to avoid postoperative constipation (27).…”

Section: Postoperative Constipationmentioning

confidence: 99%

Analysis of factors associated with postoperative complications after primary hypospadias repair: a retrospective study

Yang

Tang

2022

Transl Androl Urol

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Background: To determine the risk factors for postoperative complications after primary hypospadias repair. Hypospadias has a high postoperative complication rate, and the risk factors of postoperative complications have attracted extensive attention.Methods: A total of 857 children who received primary surgical repair for hypospadias in our center between 3 January 2017 and 29 January 2021 were retrospectively analyzed. The collected data included age at time of surgery, type of hypospadias, body mass index (BMI), surgeon, operation time, length of reconstructed urethra, method of anesthesia (general anesthesia or general anesthesia combined with caudal anesthesia), and postoperative constipation. The risk factors for postoperative complications were analyzed by multivariate analysis. Results:The follow-up time in this study was 6-54 months, with a mean follow-up time of 29 months. A total of 96 (11.2%) of the 857 pediatric patients had postoperative complications, including 44 (45.8%) cases of urethral fistula, 14 (14.6%) cases of urethral stricture, 5 (5.2%) cases of urethral diverticula, 5 (5.2%) cases of distal dehiscence, 3 (3.1%) cases of poor exposure, 2 (2.1%) cases of residual curvature, 1 (1.0%) case of penoscrotal transposition, 6 (6.3%) cases of urethral stricture and diverticulum, 6 (6.3%) cases of urethral fistula and diverticulum, 3 (3.1%) cases of urethral fistula and postoperative residual curvature, 2 (2.1%) cases of urethral fistula and distal dehiscence, and 1 (1.0%) case each of urethral fistula and transposition, urethral diverticulum and poor exposure, urethral stricture and poor exposure, distal dehiscence and transposition, and residual curvature and transposition. After univariate analysis, type of hypospadias (P=0.038), operation time (P<0.001), length of reconstructed urethra (P=0.007), and postoperative constipation (P=0.019) were included in the multivariate logistic regression analysis. The results showed that postoperative constipation was an independent risk factor for complications [P=0.027, odds ratio (OR) =1.793, confidence interval (CI):1.067 to 3.012].Conclusions: Postoperative constipation is an important influencing factor for postoperative complications following primary hypospadias repair. Therefore, defecation management should be strengthened for hypospadias patients during the perioperative period.

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Section: Postoperative Constipationmentioning

confidence: 99%

Analysis of factors associated with postoperative complications after primary hypospadias repair: a retrospective study

Yang

Tang

2022

Transl Androl Urol

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“…However, there is variability in surgery indications, modalities, and complications between adults and children, so it is necessary to analyse data specific to children. Several small‐scale studies have shown that there are no statistically significant differences in the rates of postoperative complications between preoperative with or without MBP in paediatric bowel surgery 11,15–19 . With the passage of time and in‐depth exploration, more and more studies have been reported proposing to omit the use of MBP alone to optimize a range of perioperative management measures.…”

Section: Introductionmentioning

confidence: 99%

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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Pathophysiology and Management of Postoperative Ileus in Adults and Neonates: A Review

Mannava,

Vogler,

Markel

2024

Journal of Surgical Research

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Role of Mechanical Bowel Preparation and Perioperative Antibiotics in Pediatric Pull-Through Procedures

Cited by 4 publications

References 16 publications

Analysis of factors associated with postoperative complications after primary hypospadias repair: a retrospective study

Analysis of factors associated with postoperative complications after primary hypospadias repair: a retrospective study

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

Pathophysiology and Management of Postoperative Ileus in Adults and Neonates: A Review

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