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Evidence Summary for Prevention of Gastrointestinal Dysfunction After Laparoscopic Surgery

  • Review Article
  • Published:
Indian Journal of Surgery Aims and scope Submit manuscript

A Correction to this article was published on 10 October 2022

This article has been updated

Abstract

Post-operative gastrointestinal dysfunction (PGD) leading to nausea, vomiting, and abdominal distension are common complications after laparoscopic surgery for abdominal diseases. However, there is still a lack of evidence-based guidelines or evidence summaries for the prevention of Post-operative gastrointestinal dysfunction. The purpose of this study is to retrieve and summarize the best evidence for the prevention of post-operative gastrointestinal dysfunction. Evidence, including guidelines, systematic reviews, meta-analyses, expert consensus, and evidence summaries related to the prevention of post-operative gastrointestinal dysfunction were retrieved from Chinese and English electronic databases up to November 2021. Appraisal of guidelines for research and evaluation, A MeaSurement Tool to Assess Systematic Reviews [AMSTAR], the JBI literature quality assessment tool, and the JBI Evidence Pre-ranking and Evidence Recommendation Grade System were used. A total of 4 guidelines, 1 evidence summary, and 5 expert consensus, as well as 17 systematic reviews and meta-analyses were included in our study. We summarized 29 pieces of evidence from 19 aspects of peri-operative period as follows: 9 level I, 13 level II, 5 level III, and 2 level IV pieces of evidence. The evidence recommendation was grade A for 18 pieces of evidence, and grade B for 11. As PGD remains a common complication of laparoscopic surgery, the 29 pieces of evidence summarized in this study can provide some reference for the prevention and management of gastrointestinal dysfunction after laparoscopic surgery.

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Data Availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Change history

Abbreviations

AGREE II:

Appraisal of Guidelines for Research and Evaluation II

AMSTAR:

A MeaSurement Tool to Assess systematic Reviews

CBMdisc:

China Biology Medicine disc

CGC:

China Guideline Clearinghouse

CNKI:

China National Knowledge Infrastructure

ERAS:

Enhanced recovery after surgery

GIN:

Guideline International Network

JBI:

Joanna Briggs Institute

NICE:

National Institute of Clinical Evidence

PGD:

Post-operative gastrointestinal dysfunction

RNAO:

Registered Nurses’ Association of Ontario

SIGN:

Scottish Intercollegiate Guidelines Network

References

  1. Schwab K, Smith R, Brown V, Whyte M, Jourdan I (2017) Evolution of stereoscopic imaging in surgery and recent advances. World J Gastrointest Endosc 9(8):368–377

    Article  PubMed  PubMed Central  Google Scholar 

  2. Sozzi G, Petrillo M, Gallotta V, Di Donna MC, Ferreri M, Scambia G et al (2020) Laparoscopic laterally extended endopelvic resection procedure for gynecological malignancies. Int J Gynecol Cancer 30(6):853–859

    Article  PubMed  Google Scholar 

  3. Ge B, Zhao H, Lin R, Wang J, Chen Q, Liu L et al (2017) Influence of gum-chewing on postoperative bowel activity after laparoscopic surgery for gastric cancer: a randomized controlled trial. Medicine (Baltimore) 96(13):e6501

    Article  PubMed  Google Scholar 

  4. Isazadehfar K, Entezariasl M, Shahbazzadegan B, Nourani Z, Shafaee Y (2017) The comparative study of ondansetron and metoclopramide effects in reducing nausea and vomiting after laparoscopic cholecystectomy. Acta Med Iran 55(4):254–258

    PubMed  Google Scholar 

  5. Nelson G, Altman AD, Nick A, Meyer LA, Ramirez PT, Achtari C et al (2016) Guidelines for pre- and intra-operative care in gynecologic/oncology surgery: Enhanced Recovery After Surgery (ERAS®) Society recommendations–Part I. Gynecol Oncol 140(2):313–322

    Article  CAS  PubMed  Google Scholar 

  6. Nelson G, Altman AD, Nick A, Meyer LA, Ramirez PT, Achtari C et al (2016) Guidelines for postoperative care in gynecologic/oncology surgery: Enhanced Recovery After Surgery (ERAS®) Society recommendations–Part II. Gynecol Oncol 140(2):323–332

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Cao H, Chen YJ, Gu XP (2021) Clinical practice guidelines for ERAS in China (Version 2021). Chin J Pract Surg 41(09):961–992

    Google Scholar 

  8. Gustafsson UO, Scott MJ, Hubner M, Nygren J, Demartines N, Francis N et al (2018) Guidelines for Perioperative Care in Elective Colorectal Surgery: Enhanced Recovery After Surgery (ERAS®) Society Recommendations: 2018. World J Surg 43(3):659–695

    Article  Google Scholar 

  9. McArthur A, Klugárová J, Yan H, Florescu S (2015) Innovations in the systematic review of text and opinion. Int J Evid Based Healthc 13(3):188–195

    Article  PubMed  Google Scholar 

  10. Brouwers MC, Kho ME, Browman GP, Burgers JS, Cluzeau F, Feder G et al (2010) AGREE II: advancing guideline development, reporting, and evaluation in health care. Prev Med 51(5):421–424

    Article  PubMed  Google Scholar 

  11. Pollock M, Fernandes RM, Hartling L (2017) Evaluation of AMSTAR to assess the methodological quality of systematic reviews in overviews of reviews of healthcare interventions. BMC Med Res Methodol 17(1):48

    Article  PubMed  PubMed Central  Google Scholar 

  12. Chen P, Li Z, Huang H, Zheng S (2020) Summary of the best evidence for non-drug management of diarrhea after laparoscopic cholecystectomy. Chin J Bas Clin Gen Surg 27(9):1121–1127

    Google Scholar 

  13. Chen L, Chen Y, Dong H (2018) Chinese expert consensus and path management guide for enhanced recovery after surgery (Version 2018). Chin J Pract Surg 38(01):1–20

    Google Scholar 

  14. Liu L, Chen Y, Cao M (2017) Consensus of Chinese experts on enhanced recovery after surgery of laparoscopic hepatectomy (Version 2017). Chin J Pract Surg 37(05):517–524

    Google Scholar 

  15. Bao H, Ge L, Liu X, Zhang M, Li Y (2019) Chinese experts consensus on enhanced recovery gynecological perioperative nursing. Chin J Mod Nurs 25(6):661–668

    Google Scholar 

  16. Anesthesiologist branch of Chinese Medical Association (2015) Consensus of anesthesia management experts to promote postoperative rehabilitation. Chin J Anesthesiol 35(2):141–148

    Google Scholar 

  17. China Laparoscopic Gastrointestinal Surgery Study Group (2020) Expert consensus on oral nutritional supplementation for gastric cancer patients with laparoscopic gastrectomy (Version 2020). Chin J Gastrointest Surg 23(7):623–628

    Google Scholar 

  18. Waller A, Forshaw K, Bryant J, Carey M, Boyes A, Sanson-Fisher R (2015) Preparatory education for cancer patients undergoing surgery: a systematic review of volume and quality of research output over time. Patient Educ Couns 23:S0738-3991(15)00229–3

    Google Scholar 

  19. Liu J, Wang J, Chen L (2021) Effects of intraoperative goal-directed fluid therapy on the outcome of elderly patients undergoing gastrointestinal surgery: a meta-analysis. Int J Anesth Resus 42(9):939–946

    CAS  Google Scholar 

  20. Yi H, Gu P, Liu Y (2020) The effects of gum chewing on gastrointestinal recovery after laparoscopic surgery: a meta-analysis. Chin Nurs Manag 20(8):1196–1203

    Google Scholar 

  21. Xue T, Hou M, Li P, Zhang L (2020) Systematic review and meta-analysis of the effects of oral carbohydrates before laparoscopic cholecystectomy in patients. Chin J Mod Nurs 26(7):883–887

    Google Scholar 

  22. Li X, Xu Z, Chen Z, Chen Y (2020) Meta-analysis of the curative effect of acupuncture on gastrointestinal dysfunction after laparoscopic surgery. J Yunnan Univ Tradit Chin Med 43(3):59–66

    Google Scholar 

  23. Ye CX, Guo F, Fang Q (2019) A meta analysis of the effect of acupoint massage in prevention of gastrointestinal complications after laparoscopic surgery in adults. Chin J Integr Nurs 5(12):43–48

    Google Scholar 

  24. Liu Y, Wang H, Feng T, Chen H (2018) Effect of external therapy of traditional Chinese Medicine on the recovery of gastrointestinal function after gynecologic laparoscopic surgery: a meta-analysis. Chin J Integr Nurs 4(9):89–93

    Article  Google Scholar 

  25. Shao Y, Wei F, Sun J, Xu H, Rui X, Zhao Z (2017) A meta-analysis of evaluating ondansetron combined with dexamethasone compared with ondansetron monotherapy on the prevention of nausea and vomiting after laparoscopic cholecystectomy. J Laparosc Surg 22(6):426–432

    Google Scholar 

  26. Wang X, Pan D, Deng H, Zhou Q (2015) Azasetron versus azasetron in combination with dexamethasone for the prophylaxis of postoperative nausea and vomiting in patients undergoing laparoscopic surgery: a meta-analysis of randomized controlled trials. Int J Anesth Resus 36(11):967–971

    CAS  Google Scholar 

  27. Zhai T, Zhou L, Jin Q, Pei L, Zhao Y, Yang X (2019) Effect of auricular point sticking on recovery of gastrointestinal function after gynecological laparoscopic surgery: a Meta-analysis. J Lanzhou Univ 45(6):30–36

    Google Scholar 

  28. Zhang L, Tao G, Zhang Z, Zhang C (2019) Meta-analysis on effect of early oral feeding on gastrointestinal function and postoperative hospital stay for patients undergoing non-gastrointestinal surgery. Nurs Rehabil J 18(11):7–14

    Google Scholar 

  29. Hu Y, Cheng X, Su X, Fu Y (2020) Auricular therapy improves gastrointestinal function in patients with gynecological laparoscopic surgery: a protocol for systematic review and meta analysis. Medicine (Baltimore) 99(49):e23421

    Article  PubMed  Google Scholar 

  30. Weibel S, Jelting Y, Pace NL, Helf A, Eberhart LH, Hahnenkamp K et al (2018) Continuous intravenous perioperative lidocaine infusion for postoperative pain and recovery in adults. Cochrane Database of Syst Rev 6(6):CD009642

    Google Scholar 

  31. Brinck EC, Tiippana E, Heesen M, Bell RF, Straube S, Moore RA et al (2018) Perioperative intravenous ketamine for acute postoperative pain in adults. Cochrane Database of Syst Rev 12(12):CD012033

    Google Scholar 

  32. Guay J, Nishimori M, Kopp S (2016) Epidural local anaesthetics versus opioid-based analgesic regimens for postoperative gastrointestinal paralysis, vomiting and pain after abdominal surgery. Cochrane Database of Syst Rev 7(7):CD001893

    Google Scholar 

  33. Nelson R, Edwards S, Tse B (2007) Prophylactic nasogastric decompression after abdominal surgery. Cochrane Database of Syst Rev 3(3):CD004929

    Google Scholar 

  34. Zhang S, Guo W, Jiao Y, Guo X, Xu L, Gao H (2021) Systematic review and meta-analysis of the effect of transcutaneous electrical acupoint stimulation on gastrointestinal function after laparoscopic surgery. Ann Palliat Med 10(11):11840–11848

    Article  PubMed  Google Scholar 

  35. Guyatt GH, Oxman AD, Vist GE, Kunz R, Falck-Ytter Y, Alonso-Coello P et al (2008) GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ 336(7650):924–926

    Article  PubMed  PubMed Central  Google Scholar 

  36. Vesale E, Roman H, Moawad G, Benoit L, Touboul C, Darai E et al (2020) Voiding dysfunction after colorectal surgery for endometriosis: a systematic review and meta-analysis. J Minim Invasive Gynecol 27(7):1490-1502.e3

    Article  PubMed  Google Scholar 

  37. Ruan D, Li J, Liu J, Li D, Ji N, Wang C et al (2021) Acupoint massage can effectively promote the recovery of gastrointestinal function after gynecologic laparoscopy. J Invest Surg 34(1):91–95

    Article  PubMed  Google Scholar 

  38. Wattchow D, Heitmann P, Smolilo D, Spencer NJ, Parker D, Hibberd T et al (2021) Postoperative ileus-an ongoing conundrum. Neurogastroenterol Motil 33(5):e14046

    Article  PubMed  Google Scholar 

  39. Sommer NP, Schneider R, Wehner S, Kalff JC, Vilz TO (2021) State-of-the-art colorectal disease: postoperative ileus. Int J Colorectal Dis 36(9):2017–2025

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

The authors would like to acknowledge Hongwen Ma, Suhuan Xu, and Ruonan Hou of the Tianjin Union Medical Center, Peking University First Hospital, and Bejing Tongren Hospital for their guidance in the preliminary preparation of this study. The quality of expert consensus and evidence summary was judged by re-evaluation of the original study by the team members.

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Author notes

  1. Qi Yuan and Xin Dan contributed equally to this work.

Authors and Affiliations

  1. Department of Operating Room Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing, Sichuan University; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China

    Qi Yuan & Li Chen

  2. Radiation Therapy and Chemotherapy for Cancer Nursing, West China Second University Hospital, Sichuan University/West China School of Nursing, Sichuan University; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China

    Xin Dan

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  1. Qi Yuan
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Contributions

QY designed the study. LC and XD carried out the data collection. LC conducted the data analysis. LC drafted the manuscript. QY and XD revised the manuscript. All the authors read and approved the final manuscript.

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Correspondence to Li Chen.

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The original online version of this article was revised: In the original version of this article, affiliation details of authors are not correct. This section has been corrected.

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Yuan, Q., Dan, X. & Chen, L. Evidence Summary for Prevention of Gastrointestinal Dysfunction After Laparoscopic Surgery. Indian J Surg 85, 262–272 (2023). https://doi.org/10.1007/s12262-022-03429-w

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  • DOI: https://doi.org/10.1007/s12262-022-03429-w

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