Use of Acetylcholinesterase Inhibitors in Reducing Time to Gastrointestinal Function Recovery following Abdominal Surgery: A Systematic Review.

IF 1.8 3区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Digestive Surgery Pub Date : 2024-01-01 Epub Date: 2023-12-13 DOI:10.1159/000535753

Luke Traeger, Nagendra Dudi-Venkata, Sergei Bedrikovetski, Hidde M Kroon, James W Moore, Tarik Sammour

{"title":"Use of Acetylcholinesterase Inhibitors in Reducing Time to Gastrointestinal Function Recovery following Abdominal Surgery: A Systematic Review.","authors":"Luke Traeger, Nagendra Dudi-Venkata, Sergei Bedrikovetski, Hidde M Kroon, James W Moore, Tarik Sammour","doi":"10.1159/000535753","DOIUrl":null,"url":null,"abstract":"Introduction: Postoperative ileus (POI) is a significant complication following abdominal surgery, increasing morbidity and mortality. The cholinergic anti-inflammatory response is one of the major pathways involved in developing POI, but current recommendations to prevent POI do not target this. This review aims to summarise evidence for the use of acetylcholinesterase inhibitors, neostigmine and pyridostigmine, to reduce the time to return of gastrointestinal function (GI) following abdominal surgery.Methods: A systematic search of various databases was performed from 1946 to May 2023. Randomised controlled trials (RCTs) on acetylcholinesterase inhibitors in intra-abdominal surgery were included. Data on time to flatus and/or stool and side effects were extracted.Results: Among 776 screened manuscripts, 8 RCTs (703 patients) investigating acetylcholinesterase inhibitors in intra-abdominal surgery were analysed. Five studies showed a significant reduction in time to flatus and/or stool by 17-47.6 h. Methodological variations, differing procedure types, and potential bias were observed. Limited studies reported side effects or length of stay.Conclusion: Acetylcholinesterase inhibitors may reduce the time for GI to return. However, current evidence is limited and biased. Further studies incorporating acetylcholinesterase inhibitors in an enhanced recovery protocol are required to address this question, especially for patients undergoing colorectal surgery.","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":" ","pages":"12-23"},"PeriodicalIF":1.8000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10946644/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Digestive Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1159/000535753","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/12/13 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Introduction: Postoperative ileus (POI) is a significant complication following abdominal surgery, increasing morbidity and mortality. The cholinergic anti-inflammatory response is one of the major pathways involved in developing POI, but current recommendations to prevent POI do not target this. This review aims to summarise evidence for the use of acetylcholinesterase inhibitors, neostigmine and pyridostigmine, to reduce the time to return of gastrointestinal function (GI) following abdominal surgery.

Methods: A systematic search of various databases was performed from 1946 to May 2023. Randomised controlled trials (RCTs) on acetylcholinesterase inhibitors in intra-abdominal surgery were included. Data on time to flatus and/or stool and side effects were extracted.

Results: Among 776 screened manuscripts, 8 RCTs (703 patients) investigating acetylcholinesterase inhibitors in intra-abdominal surgery were analysed. Five studies showed a significant reduction in time to flatus and/or stool by 17-47.6 h. Methodological variations, differing procedure types, and potential bias were observed. Limited studies reported side effects or length of stay.

Conclusion: Acetylcholinesterase inhibitors may reduce the time for GI to return. However, current evidence is limited and biased. Further studies incorporating acetylcholinesterase inhibitors in an enhanced recovery protocol are required to address this question, especially for patients undergoing colorectal surgery.

查看原文本刊更多论文

使用乙酰胆碱酯酶抑制剂缩短腹部手术后胃肠功能恢复的时间：系统综述。

导言：术后回肠梗阻（POI）是腹部手术后的一种重要并发症，会增加发病率和死亡率。胆碱能抗炎反应是发生 POI 的主要途径之一，但目前预防 POI 的建议并不以胆碱能抗炎反应为目标。本综述旨在总结使用乙酰胆碱酯酶抑制剂、新斯的明和吡啶斯的明缩短腹部手术后胃肠功能恢复时间的证据：方法：对 1946 年至 2023 年 5 月期间的各种数据库进行了系统检索。方法：对 1946 年至 2023 年 5 月期间的各种数据库进行了系统检索，纳入了有关乙酰胆碱酯酶抑制剂在腹腔内手术中应用的随机对照试验（RCT）。结果：在筛选出的 776 篇手稿中，对 8 项研究乙酰胆碱酯酶抑制剂在腹腔内手术中应用的 RCT（703 名患者）进行了分析。五项研究显示，排气和/或排便时间明显缩短了 17-47.6 小时。研究中发现了方法上的差异、不同的手术类型以及潜在的偏差。有限的研究报告了副作用或住院时间：结论：乙酰胆碱酯酶抑制剂可缩短胃肠功能恢复时间。结论：乙酰胆碱酯酶抑制剂可缩短胃肠功能恢复时间，但目前的证据有限且存在偏差。需要进一步研究将乙酰胆碱酯酶抑制剂纳入增强恢复方案，以解决这一问题，尤其是针对接受结直肠手术的患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Digestive Surgery 医学-外科

CiteScore

4.90

自引率

3.70%

发文量

审稿时长

3 months

期刊介绍： ''Digestive Surgery'' presents a comprehensive overview in the field of gastrointestinal surgery. Interdisciplinary in scope, the journal keeps the specialist aware of advances in all fields that contribute to improvements in the diagnosis and treatment of gastrointestinal disease. Particular emphasis is given to articles that evaluate not only recent clinical developments, especially clinical trials and technical innovations such as new endoscopic and laparoscopic procedures, but also relevant translational research. Each contribution is carefully aligned with the need of the digestive surgeon. Thus, the journal is an important component of the continuing medical education of surgeons who want their practice to benefit from a familiarity with new knowledge in all its dimensions.