Open AccessGastrografin reduces the need for additional surgery in postoperative small bowel obstruction patients without long tube insertion: A meta‐analysis
Author(s) -
Ishizuka Mitsuru,
Shibuya Norisuke,
Takagi Kazutoshi,
Iwasaki Yoshimi,
Hachiya Hiroyuki,
Aoki Taku,
Kubota Keiichi
Publication year - 2019
Publication title -
annals of gastroenterological surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.308
H-Index - 15
ISSN - 2475-0328
DOI - 10.1002/ags3.12223
Subject(s) - meta analysis , medicine , cochrane library , confidence interval , surgery , relative risk , complication , medline , political science , law
Background Small bowel obstruction (SBO) is a well‐known major postoperative complication requiring immediate diagnosis and treatment to avoid additional invasive surgical procedures. Water‐soluble contrast medium is often given not only for diagnosis but also for treatment. Although numerous studies have investigated the significance of this treatment, no consensus has yet been established regarding its indications and efficacy. Objective To explore whether Gastrografin can reduce the need for additional surgery in patients with postoperative SBO (PSBO). Methods We carried out a comprehensive electronic search of the literature (Cochrane Library, MEDLINE, PubMed and the Web of Science) up to February 2017 to identify studies that had shown efficacy of Gastrografin in reducing the need for surgery in patients with PSBO. To integrate the individual effects of Gastrografin, a meta‐analysis was done using random‐effects models to calculate the risk ratio (RR) and 95% confidence interval (CI), and heterogeneity was analyzed using I 2 statistics. Results Twelve studies involving a total of 1153 patients diagnosed as having PSBO were included in this meta‐analysis. Not all patients received long‐tube insertion. Among 580 patients who received Gastrografin, 100 (17.2%) underwent surgery, whereas among 573 patients who did not receive Gastrografin, 143 (25.0%) underwent surgery. Giving Gastrografin significantly reduced the need for surgery (RR, 0.66; 95% CI, 0.46‐0.95; P = 0.02; I 2 = 52%) in comparison with patients who did not receive Gastrografin. Conclusion Results of this meta‐analysis show that giving Gastrografin reduces the need for surgery in PSBO patients without long‐tube insertion.