Gastrointestinal recovery after surgery: protocol for a systematic review
Suzanne Edwards,
Michael Horowitz,
Karen L Jones,
Guy J Maddern,
Joshua G Kovoor,
Brandon Stretton,
Jonathan Henry W Jacobsen,
Aashray K Gupta,
Christopher D Ovenden,
Joseph N Hewitt,
John M Glynatsis,
Kaitryn Campbell,
Gayatri P Asokan,
David R Tivey,
Wendy J Babidge,
Christopher K Rayner,
Adrian A Anthony,
Markus I Trochsler,
Peter J Hewett
Affiliations
Suzanne Edwards
Adelaide Health Technology Assessment, The University of Adelaide, Adelaide, South Australia, Australia
Michael Horowitz
The University of Adelaide Faculty of Health and Medical Sciences, Adelaide, South Australia, Australia
Karen L Jones
The University of Adelaide Faculty of Health and Medical Sciences, Adelaide, South Australia, Australia
Guy J Maddern
Research, Audit and Academic Surgery, Royal Australasian College of Surgeons, Adelaide, South Australia, Australia
Joshua G Kovoor
medical practitioner
Brandon Stretton
3Royal Adelaide Hospital, Adelaide, SA, Australia
Jonathan Henry W Jacobsen
Australian Safety and Efficacy Register of New Interventional Procedures–Surgical, Royal Australasian College of Surgeons, Adelaide, South Australia, Australia
Aashray K Gupta
medical practitioner
Christopher D Ovenden
University of Adelaide, Discipline of Surgery, Womens and Childrens Hospital Adelaide, Adelaide, South Australia, Australia
Joseph N Hewitt
University of Adelaide, Discipline of Surgery, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
John M Glynatsis
Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
Kaitryn Campbell
Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
Gayatri P Asokan
University of Adelaide, Discipline of Surgery, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
David R Tivey
University of Adelaide, Discipline of Surgery, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
Wendy J Babidge
University of Adelaide, Discipline of Surgery, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
Christopher K Rayner
The University of Adelaide Faculty of Health and Medical Sciences, Adelaide, South Australia, Australia
Adrian A Anthony
University of Adelaide, Discipline of Surgery, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
Markus I Trochsler
University of Adelaide, Discipline of Surgery, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
Peter J Hewett
University of Adelaide, Discipline of Surgery, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
Introduction Gastrointestinal recovery after surgery is of worldwide significance. Postoperative gastrointestinal dysfunction is multifaceted and known to represent a major source of postoperative morbidity, however, its significance to postoperative care across all surgical procedures is unknown. The complexity of postoperative gastrointestinal recovery is poorly defined within gastrointestinal surgery, and even less so outside this field. To inform the clinical care of surgical patients worldwide, this systematic review and meta-analysis will aim to characterise the duration of postoperative gastrointestinal recovery that can be expected across all surgical procedures and determine the associations between factors that may affect this.Methods and analysis MEDLINE, Embase, Cochrane Library and CINAHL will be searched for studies reporting the time to first postoperative passage of stool after any surgical procedure. We will screen records, extract data and assess risk of bias in duplicate. Forest plots will be constructed for time to postoperative gastrointestinal recovery, as assessed by various outcome measures. Because of potential heterogeneity, a random-effects model will be used throughout the meta-analysis. Funnel plots will be used to test for publication bias. Meta-regressions will be undertaken where the outcome is the mean time to first postoperative passage of stool, with potential predictors and confounders being patient characteristics, postoperative outcomes and surgical factors.Ethics and dissemination This study will not involve human or animal subjects and, thus, does not require ethics approval. The outcomes will be disseminated via publication in peer-reviewed scientific journal(s) and presentations at scientific conferences.PROSPERO registration number CRD42021256210.
