Sarmiento-Altamirano Doris, Arce-Jara Daniel, Balarezo-Guerrero Pablo, Valdivieso-Espinoza Rafael
Faculty of Medicine, University of Azuay, Cuenca, Ecuador; Faculty of Public Health and Administration, Cayetano Heredia Peruvian University, San Martín de Porres District, Peru.
Faculty of Medicine, University of Azuay, Cuenca, Ecuador.
J Gastrointest Surg. 2025 Mar;29(3):101960. doi: 10.1016/j.gassur.2025.101960. Epub 2025 Jan 7.
Postoperative ileus is a surgical complication that affects intestinal motility. There are measures to reduce this problem, but not all have conclusive evidence. This study aimed to determine which measures, such as coffee, chewing gum (CG), electroacupuncture (EA), daikenchuto (DKT), and prokinetic agents, are most effective in reducing postoperative ileus in patients undergoing gastrointestinal surgeries.
A systematic search was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines on Google Scholar, PubMed, ScienceDirect, and Web of Science. The following measures were studied to define postoperative ileus: time to passage of the first flatus and time to passage of the first stool. The mean differences were determined by subgroup analyses.
Of 176 studies, 37 were selected for the systematic review, which involved 4647 patients. The reduction in time to passage of the first flatus was -18.33 h (95% CI, -26.46 to -10.20; P <.01) for EA, -5.83 h (95% CI, -9.40 to -2.26; P <.01) for DKT, -14.87 h (95% CI, -26.84 to -2.90; P =.01) for CG, and -1.90 h (95% CI, -8.28 to 4.48; P =.56) for coffee. The reduction in time to passage of the first stool was -32.27 h (95% CI, -39.28 to -25.26; P <.01) for prokinetic agents, -23.05 h (95% CI, -29.31 to -16.78; P <.01) for CG, -12.89 h (95% CI, -17.78 to -8.01; P <.01) for coffee, -19.76 h (95% CI, -32.79 to -6.72; P <.01) for EA, and -0.70 h (95% CI, -25.51 to 26.92; P =.96) for DKT.
The use of CG, EA, and prokinetic agents decreased the time to passage of the first flatus and time to passage of the first stool and indirectly reduced postoperative ileus.
术后肠梗阻是一种影响肠道蠕动的手术并发症。有多种措施可减少这一问题，但并非所有措施都有确凿证据。本研究旨在确定哪些措施，如咖啡、口香糖（CG）、电针（EA）、大建中汤（DKT）和促动力药物，在减少接受胃肠手术患者的术后肠梗阻方面最为有效。
按照系统评价和Meta分析的首选报告项目指南，在谷歌学术、PubMed、ScienceDirect和科学网上进行了系统检索。研究了以下措施来定义术后肠梗阻：首次排气时间和首次排便时间。通过亚组分析确定平均差异。
在176项研究中，37项被选入系统评价，涉及4647例患者。电针组首次排气时间缩短-18.33小时（95%CI，-26.46至-10.20；P<.01），大建中汤组缩短-5.83小时（95%CI，-9.40至-2.26；P<.01），口香糖组缩短-14.87小时（95%CI，-26.84至-2.90；P=.01），咖啡组缩短-1.90小时（95%CI，-8.28至4.48；P=.56）。促动力药物组首次排便时间缩短-32.27小时（95%CI，-39.28至-25.26；P<.01），口香糖组缩短-23.05小时（�CI，-29.31至-16.78；P<.01），咖啡组缩短-12.89小时（95%CI，-17.78至-8.01；P<.01），电针组缩短-19.76小时（95%CI，-32.79至-6.72；P<.01），大建中汤组缩短-0.70小时（95%CI，-25.51至26.92；P=.96）。
使用口香糖、电针和促动力药物可缩短首次排气时间和首次排便时间，间接减少术后肠梗阻。
