Evidence map›Paper›PMID 27488952›Full record

ArticleLangenbeck's archives of surgery2017

Postoperative ileus: in search of an international consensus on definition, diagnosis, and treatment.

Daniel Gero, Olivier Gié, Martin Hübner, Nicolas Demartines, Dieter Hahnloser

Registry-linked trialAbstract readConsensus Statement
PubMed Publisher
In one paragraph

Article in Langenbeck's archives of surgery, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04001985 (Nasogastric Tube Clamping Trial), which is not on this map. Cited by 50 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
50citing papers in PubMed, 7 pooled it
4.7field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04001985 naunknown statusnot on this mapstarted 2019, after this paper: background citation

Nasogastric Tube Clamping Trial: Is it Useful? A Proposed Algorithm for Removal.

TypeinterventionalSponsorUniversity of Illinois College of Medicine at PeoriaRan2019 to 2020Enrolled150ConditionsSmall Bowel Obstruction, IleusArmsNo clamp trial, Clamp trial
3 · Its place in the literature

Who cites it

50 citing papers in PubMed, 7 syntheses or guidelines pooled it, 103 citations in OpenAlex.

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  6. The Impact of Sham Feeding with Chewing Gum on Postoperative Ileus Following Colorectal Surgery: a Meta-Analysis of Randomised Controlled Trials.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2020
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 1 institution in 1 country.

Daniel GeroDepartment of Visceral Surgery, University Hospital CHUV, Rue du Bugnon 46, CH-1011, Lausanne, Switzerland.
Olivier GiéDepartment of Visceral Surgery, University Hospital CHUV, Rue du Bugnon 46, CH-1011, Lausanne, Switzerland.
Martin HübnerDepartment of Visceral Surgery, University Hospital CHUV, Rue du Bugnon 46, CH-1011, Lausanne, Switzerland.
Nicolas DemartinesDepartment of Visceral Surgery, University Hospital CHUV, Rue du Bugnon 46, CH-1011, Lausanne, Switzerland.
Dieter HahnloserDepartment of Visceral Surgery, University Hospital CHUV, Rue du Bugnon 46, CH-1011, Lausanne, Switzerland. dieter.hahnloser@chuv.ch.
University Hospital of Lausanne · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposePostoperative ileus (POI) is a frequent complication after abdominal surgery; nonetheless, it remains poorly defined. Our aim was to achieve an international consensus among leading colorectal surgeons on definition, prevention, and treatment of POI.

methodsThirty-five experts from five continents participated in a three-round Delphi process. Round 1 contained open-ended questions on POI and postoperative nausea and vomiting (PONV). Round 2 included closed-ended questions. Round 3 measured agreement on a 5-point Likert scale. Consensus was defined when items were rated as agree or strongly agree by at least 70 % of the experts.

resultsExperts reached following consensus: POI is a temporary inhibition (86 %) of gastrointestinal motility after surgical intervention due to non-mechanical causes (89 %) and prevents sufficient oral intake (96 %). Abdominal distension/tenderness are the most relevant clinical signs (71 %). Nasogastric tube placement is not mandatory (78 %) but can be removed without previous clamping (81 %)/gastrointestinal contrast study (100 %). Preventive measures are recommended to decrease the risk of POI (96 %): narcotic sparing analgesia (89 %) and fluid optimization (74 %). Treatment of POI should include stimulation of ambulation (96 %) and stop of opioids (74 %). Total parenteral nutrition is recommended from the 7th day without sufficient oral intake (81 %). There was no consensus on the ranking of POI's symptoms, on the imaging modality of choice for the diagnosis of POI, neither on the difference between POI and PONV.

conclusionsThis Delphi study achieved consensus on the definition, relevant clinical signs, prevention, treatment, and supportive care of POI. Areas of non-consensus were identified (necessity and modality of radiologic imaging to establish the diagnosis, difference between POI and PONV), giving opportunity for further research.

Indexed as

IleusPostoperative ComplicationsAnalgesics, OpioidDelphi TechniqueHumansPostoperative CareAnalgesics, OpioidConsensusDelphi methodIleusPONVPostoperative ileusPostoperative nausea and vomiting

Identifiers

PMID27488952
OpenAlexW2485585346

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.