We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Clinical Endpoint, Early Detection, and Differential Diagnosis of Postoperative Ileus: A Systematic Review of the Literature.
- Authors
Wu, Zhouqiao; Boersema, Geesien S.a.; Dereci, adem; Menon, anand G.; Jeekel, Johannes; Lange, Johan F.
- Abstract
Background: This systematic review summarizes evidence regarding clinical endpoints, early detection, and differential diagnosis of postoperative ileus (POI). Methods: Using MEDLINE, EMBASE, Cochrane, and Web-of-Science, we identified 2,084 articles. Risk of bias and level of evidence (LOE) of the included articles were determined, and relevant results were summarized. Results: Eleven articles were included, most of which with substantial risks of bias. Bowel motility studies revealed that defecation together with solid food tolerance is the most representative clinical endpoint of POI (LOE: 2b); other clinical signs (e.g. bowel sounds, passage of flatus) did not correlate with a full recovery of bowel motility. Inflammatory parameters including interleukin (IL)-6, IL-1, and TNF-α might assist in an early detection of prolonged POI (LOE: 4). Clinical manifestations (e.g. nausea, vomiting, abdominal distension, bowel sounds, flatus) and X-ray examinations provided limited aid to the differential diagnosis of POI, while CT with Gastrografin had the best specificity and sensitivity (both 100%; LOE: 1c). Conclusions: Postoperative defecation together with tolerance of solid food intake seems to be the best clinical endpoint of POI. CT has the best differential diagnostic value between POI and other complications. Prospective studies with a high LOE are in great need. © 2014 S. Karger AG, Basel
- Subjects
BOWEL obstructions; DEFECATION; INTERLEUKIN-6; X-rays; NAUSEA; VOMITING
- Publication
European Surgical Research, 2015, Vol 54, Issue 3/4, p127
- ISSN
0014-312X
- Publication type
Academic Journal
- DOI
10.1159/000369529