Effect evaluation of different preventive measures for ileus after abdominal operation: A systematic review and network meta-analysis
Yan Cui,
Chengzu Zhang,
Hui Zhang,
Xuan Zhang,
Yuan Tang,
Zhihang Wu,
Tianming Wang,
Quanxin Chen,
Ying Meng,
Bo Wang,
Mei Liu,
Jianfeng Yi,
Yuhong Shi,
Richeng Li,
Haibang Pan
Affiliations
Yan Cui
First School of Clinical Medicine, Gansu University of Chinese Medicine, Lanzhou, Gansu, China; Key Laboratory of Gansu Provincial Prescription Mining and Innovative Translational Laboratory, Gansu University of Chinese Medicine, Lanzhou, 730000, Gansu, China
Chengzu Zhang
First School of Clinical Medicine, Gansu University of Chinese Medicine, Lanzhou, Gansu, China
Hui Zhang
First School of Clinical Medicine, Gansu University of Chinese Medicine, Lanzhou, Gansu, China
Xuan Zhang
First School of Clinical Medicine, Gansu University of Chinese Medicine, Lanzhou, Gansu, China
Yuan Tang
First School of Clinical Medicine, Gansu University of Chinese Medicine, Lanzhou, Gansu, China
Zhihang Wu
First School of Clinical Medicine, Gansu University of Chinese Medicine, Lanzhou, Gansu, China
Tianming Wang
First School of Clinical Medicine, Gansu University of Chinese Medicine, Lanzhou, Gansu, China
Quanxin Chen
First School of Clinical Medicine, Gansu University of Chinese Medicine, Lanzhou, Gansu, China
Ying Meng
Department of Pharmacy, Expo High-tech Hospital, Zibo, Shandong, China
Bo Wang
School of Nursing, Gansu University of Chinese Medicine, Lanzhou, Gansu, China; Corresponding author.
Mei Liu
First School of Clinical Medicine, Gansu University of Chinese Medicine, Lanzhou, Gansu, China; Gansu Provincial Traditional Chinese Medicine New Product Creation Engineering Laboratory, Gansu University of Chinese Medicine, Lanzhou, 730000, Gansu, China
Jianfeng Yi
First School of Clinical Medicine, Gansu University of Chinese Medicine, Lanzhou, Gansu, China
Yuhong Shi
First School of Clinical Medicine, Gansu University of Chinese Medicine, Lanzhou, Gansu, China
Richeng Li
First School of Clinical Medicine, Gansu University of Chinese Medicine, Lanzhou, Gansu, China
Haibang Pan
First School of Clinical Medicine, Gansu University of Chinese Medicine, Lanzhou, Gansu, China; Corresponding author.
Background: Different approaches to the prevention of postoperative ileus have been evaluated in numerous randomized controlled trials. This network meta-analysis aimed to investigate the relative effectiveness of different interventions in preventing postoperative ileus. Methods: Randomized controlled trials (RCTS) on the prevention of postoperative ileus were screened from Chinese and foreign medical databases and compared. STATA software was used for network meta-analysis using the frequency method. Random-effects network meta-analysis was also used to compare all schemes directly and indirectly. Results: A total of 105 randomized controlled trials with 18,840 participants were included in this report. The results of the network meta-analysis showed that intravenous analgesia was most effective in preventing the incidence of postoperative ileus, the surface under the cumulative ranking curve (SUCRA) is 90.5. The most effective intervention for reducing the first postoperative exhaust time was postoperative abdominal mechanical massage (SUCRA: 97.3), and the most effective intervention for reducing the first postoperative defecation time was high-dose opioid antagonists (SUCRA: 84.3). Additionally, the most effective intervention for reducing the time to initiate a normal diet after surgery was accelerated rehabilitation (SUCRA: 85.4). A comprehensive analysis demonstrated the effectiveness and prominence of oral opioid antagonists and electroacupuncture (EA) combined with gum. Conclusion: This network meta-analysis determined that oral opioid antagonists and EA combined with chewing gum are the most effective treatments and optimal interventions for reducing the incidence of postoperative ileus. However, methods such as abdominal mechanical massage and coffee require further high-quality research.
