Bowel stimulation before loop ileostomy closure to reduce postoperative ileus: a multicenter, single-blinded, randomized controlled trial
Rattachement africain : ca, nz, us. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
INTRODUCTION: The objective of this study was to evaluate the impact of preoperative bowel stimulation on the development of postoperative ileus (POI) after loop ileostomy closure. METHODS: This was a multicenter, randomized controlled trial (NCT025596350) including adult (≥ 18 years old) patients who underwent elective loop ileostomy closure at 7 participating hospitals. Participants were randomly assigned (1:1) using a centralized computer-generated sequence with block randomization to either preoperative bowel stimulation or no stimulation (control group). Bowel stimulation consisted of 10 outpatient sessions within the 3 weeks prior to ileostomy closure and was performed by trained Enterostomal Therapy nurses. The primary outcome was POI, defined as an intolerance to oral food in the absence of clinical or radiological signs of obstruction, on or after postoperative day 3, that either (a) required nasogastric tube insertion; or (b) was associated with two of the following: nausea/vomiting, abdominal distension, or the absence of flatus. RESULTS: Between January 2017 and November 2020, 101 patients were randomized, and 5 patients never underwent ileostomy closure; thus, 96 patients (47 stimulated vs. 49 control) were analyzed according to a modified intention-to-treat protocol. Baseline characteristics were well balanced in both groups. The incidence of POI was lower among patients randomized to stimulation (6.4% vs. 24.5%, p = 0.034; unadjusted RR: 0.26, 95% CI 0.078-0.87). Stimulated patients also had earlier median time to first flatus (2.0 days (1.0-2.0) vs. 2.0 days (2.0-3.0), p = 0.025), were more likely to pass flatus on postoperative day 1 (46.8% vs. 22.4%, p = 0.022), and had a shorter median postoperative hospital stay (3.0 days (2.0-3.5) vs. 4.0 days (2.0-6.0), p = 0.003). CONCLUSIONS: Preoperative bowel stimulation via the efferent limb of the ileostomy reduced POI after elective loop ileostomy closure.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Bowel stimulation before loop ileostomy closure to reduce postoperative ileus: a multicenter, single-blinded, randomized controlled trial
- Date Crossref
- 19/08/2022
- Éditeur
- Springer Science and Business Media LLC
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Jewish General Hospital Division of Colon and Rectal Surgery pays non établi dans la noticeÉtablissement de santé
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North Shore Hospital Department of Surgery pays non établi dans la noticeÉtablissement de santé
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McGill University Health Centre Jewish General Hospital pays non établi dans la noticeÉtablissement de santé
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North York General Hospital Department of Surgery pays non établi dans la noticeÉtablissement de santé
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Rush University Medical Center Division of Colon and Rectal Surgery pays non établi dans la noticeÉtablissement de santé
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University Health Network Department of Surgery pays non établi dans la noticeÉtablissement de santé
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St Mary's Hospital Centre pays non établi dans la noticeÉtablissement de santé
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McGill University Department of Surgery pays non établi dans la noticeUniversité ou école supérieure
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Cleveland Clinic Department of Colorectal Surgery pays non établi dans la noticeÉtablissement de santé
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Cleveland Foundation pays non établi dans la noticeOrganisation à but non lucratif
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St. Mary's Hospital Department of Surgery pays non établi dans la noticeÉtablissement de santé
Division of Colon and Rectal Surgery — Jewish General Hospital, Department of Surgery — North Shore Hospital et Jewish General Hospital — McGill University Health Centre, avec 8 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.