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Erschienen in: Journal of Gastrointestinal Surgery 2/2020

13.08.2019 | Review Article

Therapeutic Role of Water-Soluble Contrast Media in Adhesive Small Bowel Obstruction: a Systematic Review and Meta-Analysis

verfasst von: Amanda Koh, Alfred Adiamah, Abeed Chowdhury, Mohamed Khalid Mohiuddin, Balamurali Bharathan

Erschienen in: Journal of Gastrointestinal Surgery | Ausgabe 2/2020

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Abstract

Background

Adhesive small bowel obstruction (ASBO) is a common post-operative cause of hospitalisation. Water-soluble contrast media (WSCM) has become a popular non-surgical approach to treatment. However, previous reviews have concluded with conflicting results. This meta-analysis of randomised controlled trials (RCTs) re-evaluated the therapeutic value of WSCM in the management of ASBO.

Methods

A comprehensive search of PubMed, Embase, and Cochrane databases was undertaken to identify RCTs from January 2000 to November 2018. The primary outcomes of length of stay and secondary outcomes of time to resolution, need for surgery, and mortality were extracted from the included studies. Quantitative pooling of the data was based on the random effects model.

Results

Eight hundred and seventy-nine patients from the nine studies were included in the analysis. The administration of oral WSCM reduced the length of hospital stay (weighted mean difference − 0.15 days, P < 0.0001). However, WSCM does not reduce the need for surgery (relative risk 0.84, P < 0.009) and makes no difference to mortality rate (RR 0.99, P < 1.000). The definition of time to resolution of ASBO differed between the studies, ranging from time to passing flatus, to cessation of abdominal pain, and time to initiating oral intake. The significant differences in definition precluded meaningful quantitative pooling of this outcome.

Conclusions

This meta-analysis evaluating the therapeutic value of WSCM has shown that it does not reduce the need for operative management in ASBO or impact mortality rates. It shortens hospital stay by 0.15 days (3.6 h) which is not clinically significant.
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Metadaten
Titel
Therapeutic Role of Water-Soluble Contrast Media in Adhesive Small Bowel Obstruction: a Systematic Review and Meta-Analysis
verfasst von
Amanda Koh
Alfred Adiamah
Abeed Chowdhury
Mohamed Khalid Mohiuddin
Balamurali Bharathan
Publikationsdatum
13.08.2019
Verlag
Springer US
Erschienen in
Journal of Gastrointestinal Surgery / Ausgabe 2/2020
Print ISSN: 1091-255X
Elektronische ISSN: 1873-4626
DOI
https://doi.org/10.1007/s11605-019-04341-7

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