ArticleBMC gastroenterology2019
Clinical benefit of oral lactulose for postoperative care of pateints with complicated appendicitis using propensity score matching analysis.
Article in BMC gastroenterology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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5 authors at 3 institutions in 1 country.
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Abstract
objectiveThe aim of this study was to investigate the effect of oral lactulose for pediatric patients with complicated appendicitis, who underwent appendectomy.
backgroundOral lactulose was widely used for gastrointestinal function regulation. However, clinical benefit for oral lactulose regarding its effects on recent postoperative gastrointestinal (GI) recovery and long term adhesive small bowel obstruction (ASBO) incidence, especially in the postoperative pediatric population has not yet defined.
methodsA total of 525 pediatric patients with complicated appendicitis underwent appendectomy were retrospectively reviewed. Among them, 317 cases were subjected to oral lactulose management and 208 patients without, served as control. Propensity score 1:1 matching was carried out to adjust for any potential baseline variables. In 189 paired patients, clinical outcomes, including gastrointestinal recovery variables, incidence of ABSO, as well as adverse events, were compared according to the oral lactulose administration or not.
resultsPatients who received oral lactulose administration achieved early gastrointestinal function recovery, including, first bowel movement (Risk ratio [RR], 1.34; 95% confidence interval [CI] 1.02-2.63, p = 0.005) and first solid feeding (RR, 1.26; 95% CI, 1.01-1.92, p = 0.012). A lower occurrence of ASBO (OR, 0.47; 95% CI, 0.25-0.87; p = 0.011) and lower constipation (Odds ratio [OR], 0.25; 95% CI, 0.13-0.46; p < 0.001), were noted in patients received oral lactulose than in patients without. Furthermore, significantly fewer patients required readmission (OR, 0.56; 95% CI, 0.32-0.99; p = 0.031) and reoperation (OR, 0.29; 95% CI, 0.09-0.92; p = 0.022) in the patients who received oral lactulose administration.
conclusionsBeneficial effects of oral lactulose administration in pediatric patients undergone appendectomy were indicated, such as accelerating gastrointestinal function recovery, reducing the postoperative incidence of ASBO and constipation, so reduced readmission and reoperation.
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