Evidence map›Paper›PMID 37330988›Full record

SynthesisTechniques in coloproctology2023

Clinical management of high-output stoma: a systematic literature review and meta-analysis.

H Lederhuber, L H Massey, V E Kantola, M R S Siddiqui, A E Sayers, F D McDermott, I R Daniels, N J Smart

Registry-linked trialAbstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Techniques in coloproctology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06917963 (Study of Treatment With Intensified Omeprazole Treatment to Prevent High Output Stoma 1), which is not on this map. Cited by 13 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed, 2 pooled it
–field-weighted citation impact
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.

NCT06917963 narecruitingnot on this mapstarted 2025, after this paper: background citation

Study of Treatment With Intensified Omeprazole Treatment to Prevent High Output Stoma 1: a Randomized, Non-blinded, Controlled Trial

TypeinterventionalSponsorMedical University of GdanskRan2025 to 2027Enrolled80ConditionsStoma - Ileostomy, High Output Stoma, Colon Cancer, IBD (Inflammatory Bowel Disease)ArmsIntensified intravenous omeprazole therapy (loading dose 80 mg IV, then 40 mg IV twice daily at 6:00 AM and 6:00 PM), Standard intravenous omeprazole therapy (40 mg IV once daily at 6:00 AM).
3 · Its place in the literature

Who cites it

13 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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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

8 authors.

H LederhuberRoyal Devon University HealthCare NHS Foundation Trust, Exeter, UK. hans.lederhuber@nhs.net.ORCID 0000-0002-9786-8054
L H MasseySt. Mark's The National Bowel Hospital and Academic Institute, London, UK.ORCID 0000-0002-1699-8034
V E KantolaRoyal Devon University HealthCare NHS Foundation Trust, Exeter, UK.ORCID 0000-0002-4668-7915
M R S SiddiquiSouth Tyneside and Sunderland NHS Foundation Trust, Sunderland, UK.ORCID 0000-0002-3241-9100
A E SayersRoyal Devon University HealthCare NHS Foundation Trust, Exeter, UK.ORCID 0000-0001-8561-4834
F D McDermottRoyal Devon University HealthCare NHS Foundation Trust, Exeter, UK.ORCID 0000-0002-4891-1191
I R DanielsRoyal Devon University HealthCare NHS Foundation Trust, Exeter, UK.ORCID 0000-0002-9114-0812
N J SmartRoyal Devon University HealthCare NHS Foundation Trust, Exeter, UK.ORCID 0000-0002-3043-8324

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeHigh output is a common complication after stoma formation. Although the management of high output is described in the literature, there is a lack of consensus on definitions and treatment. Our aim was to review and summarise the current best evidence.

methodsMEDLINE, Cochrane Library, BNI, CINAHL, EMBASE, EMCARE, and ClinicalTrials.gov were searched from 1 Jan 2000 to 31 Dec 2021 for relevant articles on adult patients with a high-output stoma. Patients with enteroatmospheric fistulas and case series/reports were excluded. Risk of bias was assessed using RoB2 and MINORS. The review was registered in PROSPERO (CRD42021226621).

resultsThe search strategy identified 1095 articles, of which 32 studies with 768 patients met the inclusion criteria. These studies comprised 15 randomised controlled trials, 13 non-randomised prospective trials, and 4 retrospective cohort studies. Eighteen different interventions were assessed. In the meta-analysis, there was no difference in stoma output between controls and somatostatin analogues (g - 1.72, 95% CI - 4.09 to 0.65, p = 0.11, I

conclusionThere is limited high-quality evidence favouring any specific widely used drug over the others in the management of high-output stoma. Evidence, however, is weak due to inconsistent definitions, risk of bias and poor methodology in the existing studies. We recommend the development of validated core descriptor and outcomes sets, as well as patient-reported outcome measures.

Indexed as

Surgical StomasAdultHumansProspective StudiesRetrospective StudiesIleostomyJejunostomyMeta-analysisPostoperative complicationsShort bowel syndrome

Identifiers

PMID37330988

What OpenQuestion holds

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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.