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Prucalopride and Bowel Function Post Gastrointestinal Surgery: Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Talwar, Gaurav; Sharma, Sahil; McKechnie, Tyler; Yang, Shuling; Khamar, Jigish; Hong, Dennis; Doumouras, Aristithes; Eskicioglu, Cagla.
Afiliación
  • Talwar G; Department of Surgery, Division of General Surgery, McMaster University, Hamilton, ON, Canada.
  • Sharma S; Department of Surgery, Division of General Surgery, McMaster University, Hamilton, ON, Canada.
  • McKechnie T; Department of Surgery, Division of General Surgery, McMaster University, Hamilton, ON, Canada.
  • Yang S; Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada.
  • Khamar J; Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada.
  • Hong D; Department of Surgery, Division of General Surgery, McMaster University, Hamilton, ON, Canada.
  • Doumouras A; Department of Surgery, Division of General Surgery, St. Joseph's Healthcare, Hamilton, ON, Canada.
  • Eskicioglu C; Department of Surgery, Division of General Surgery, McMaster University, Hamilton, ON, Canada.
Am Surg ; 90(6): 1682-1701, 2024 Jun.
Article en En | MEDLINE | ID: mdl-38530772
ABSTRACT

BACKGROUND:

Prolonged postoperative ileus (PPOI) contributes to morbidity and prolonged hospitalization. Prucalopride, a selective 5-hydroxytryptamine receptor agonist, may enhance bowel motility. This review assesses whether the perioperative use of prucalopride compared to placebo is associated with accelerated return of bowel function post gastrointestinal (GI) surgery.

METHODS:

OVID, CENTRAL, and EMBASE were searched as of January 2024 to identify randomized controlled trials (RCTs) comparing prucalopride and placebo for prevention of PPOI in adult patients undergoing GI surgery. The primary outcomes were time to stool, time to flatus, and time to oral tolerance. The secondary outcomes were incidence of PPOI, length of stay (LOS), postoperative complications, adverse events, and overall costs. The Cochrane risk of bias tool for randomized trials and the Grading of Recommendations, Assessment, Development, and Evaluations framework were used. An inverse variance random effects model was used.

RESULTS:

From 174 citations, 3 RCTs with 139 patients in each treatment group were included. Patients underwent a variety of GI surgeries. Patients treated with prucalopride had a decreased time to stool (mean difference 36.82 hours, 95% CI 59.4 to 14.24 hours lower, I2 = 62%, low certainty evidence). Other outcomes were not statistically significantly different (very low certainty evidence). Postoperative complications and adverse events could not be meta-analyzed due to heterogeneity; yet individual studies suggested no significant differences (very low certainty evidence).

DISCUSSION:

Current RCT evidence suggests that prucalopride may enhance postoperative return of bowel function. Larger RCTs assessing patient important outcomes and associated costs are needed before routine use of this agent.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias / Procedimientos Quirúrgicos del Sistema Digestivo / Benzofuranos / Ensayos Clínicos Controlados Aleatorios como Asunto / Ileus Límite: Humans Idioma: En Revista: Am Surg Año: 2024 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias / Procedimientos Quirúrgicos del Sistema Digestivo / Benzofuranos / Ensayos Clínicos Controlados Aleatorios como Asunto / Ileus Límite: Humans Idioma: En Revista: Am Surg Año: 2024 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Estados Unidos