Evidence map›Paper›PMID 32459069›Full record

SynthesisBJS open2020

Safety and efficacy of laxatives after major abdominal surgery: systematic review and meta-analysis.

N N Dudi-Venkata, W Seow, H M Kroon, S Bedrikovetski, J W Moore, M L Thomas, T Sammour

Open access · goldAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BJS open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 2 pooled it
0.8field-weighted citation impact, top 27% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 2 syntheses or guidelines pooled it, 10 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Article
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

7 authors at 2 institutions in 1 country.

N N Dudi-VenkataColorectal Unit, Department of Surgery, Royal Adelaide Hospital, Adelaide, South Australia, Australia.ORCID 0000-0002-9775-3599
W SeowDiscipline of Surgery, Faculty of Health and Medical Sciences, School of Medicine, University of Adelaide, Adelaide, South Australia, Australia.ORCID 0000-0002-5024-1000
H M KroonColorectal Unit, Department of Surgery, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
S BedrikovetskiDiscipline of Surgery, Faculty of Health and Medical Sciences, School of Medicine, University of Adelaide, Adelaide, South Australia, Australia.
J W MooreColorectal Unit, Department of Surgery, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
M L ThomasColorectal Unit, Department of Surgery, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
T SammourColorectal Unit, Department of Surgery, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
Royal Adelaide Hospital · AUThe University of Adelaide · AU

Funding

Medtronic Colorectal Research Fellowship Supplementary Scholarship a1753714Royal Australasian College of Surgeons W.G. Norman Research Scholarship (RACS ID 187648)
6 · The paper itself

Abstract

backgroundRecovery of gastrointestinal function is often delayed after major abdominal surgery, leading to postoperative ileus (POI). Enhanced recovery protocols recommend laxatives to reduce the duration of POI, but evidence is unclear. This systematic review aimed to assess the safety and efficacy of laxative use after major abdominal surgery.

methodsOvid MEDLINE, Embase, Cochrane Library and PubMed databases were searched from inception to May 2019 to identify eligible RCTs focused on elective open or minimally invasive major abdominal surgery. The primary outcome was time taken to passage of stool. Secondary outcomes were time taken to tolerance of diet, time taken to flatus, length of hospital stay, postoperative complications and readmission to hospital.

resultsFive RCTs with a total of 416 patients were included. Laxatives reduced the time to passage of stool (mean difference (MD) -0·83 (95 per cent c.i. -1·39 to -0·26) days; P = 0·004), but there was significant heterogeneity between studies for this outcome measure. There was no difference in time to passage of flatus (MD -0·17 (-0·59 to 0·25) days; P = 0·432), time to tolerance of diet (MD -0·01 (-0·12 to 0·10) days; P = 0·865) or length of hospital stay (MD 0·01(-1·36 to 1·38) days; P = 0·992). There were insufficient data available on postoperative complications for meta-analysis.

conclusionRoutine postoperative laxative use after major abdominal surgery may result in earlier passage of stool but does not influence other postoperative recovery parameters. Better data are required for postoperative complications and validated outcome measures.

Indexed as

AbdomenData ManagementDefecationElective Surgical ProceduresHumansIleusLaxativesPostoperative ComplicationsRandomized Controlled Trials as TopicTime FactorsLaxatives

Identifiers

PMID32459069
PMCPMC7397346
OpenAlexW3029792587

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.