Perioperative bowel regimens following posterior spinal fusions for adolescent idiopathic scoliosis: a systematic review.

IF 1.7 Q2 MEDICINE, GENERAL & INTERNAL
Annals of Medicine and Surgery Pub Date : 2025-01-31 eCollection Date: 2025-02-01 DOI:10.1097/MS9.0000000000002928
Lee R Benaroch, Ali Ahmadi Pirshahid, Kevin Morash, Supriya Singh, Parham Rasoulinejad, Debra Bartley, Timothy Carey, Alla Iansavichene, Patrick Thornley
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引用次数: 0

Abstract

Background: Bowel morbidity after posterior spinal fusions (PSFs) for adolescent idiopathic scoliosis (AIS) delays the advancement of postoperative oral diet and discharge. This systematic review aims to investigate the effectiveness of perioperative bowel regimens in reducing length of stay and postoperative bowel morbidity in these patients.

Materials and methods: We systematically searched MEDLINE, Embase, Cochrane, SPORTDiscus, and CINAHL for articles reporting on clinical results of PSFs for AIS patients. Demographic data, mean operative time and estimated blood loss, length of stay, time to first flatus and/or bowel movement, first oral intake, and postoperative pain scores were extracted from the selected studies.

Results: Six articles (n = 468 patients) met the final inclusion criteria. Only one study, which assessed oral methylnaltrexone, reported a significant reduction in the mean hospital length of stay (0.60 days, P < 0.05) and postoperative abdominal distension (17% versus 40%, P < 0.05); however, it was also the only study to report a significantly increased mean operative time (38.9 min, P = 0.03) and estimated blood loss (111.1 mL, P = 0.05) compared to the treatment group. Time to flatus, regular diet, postoperative opioid consumption, and pain scores did not differ significantly in any of the reported studies.

Conclusion: There is limited evidence to demonstrate any specific perioperative bowel regimen will decrease postpreparative bowel morbidity and/or length of stay. While not a treatment in isolation, oral methylnaltrexone may be a safe and effective adjunct to standard postoperative bowel regimens and may have a better patient tolerance profile.

后路脊柱融合术治疗青少年特发性脊柱侧凸围手术期肠治疗方案:一项系统综述。
背景:青少年特发性脊柱侧凸(AIS)后路脊柱融合术(PSFs)后肠道发病率延迟了术后口腔饮食和排泄的进展。本系统综述旨在探讨围手术期肠道方案在减少这些患者的住院时间和术后肠道发病率方面的有效性。材料和方法:我们系统地检索了MEDLINE、Embase、Cochrane、SPORTDiscus和CINAHL,检索了关于AIS患者psf临床结果的文章。从选定的研究中提取了人口统计数据、平均手术时间和估计失血量、住院时间、首次放屁和/或排便时间、首次口服摄入量和术后疼痛评分。结果:6篇文章(n = 468例)符合最终纳入标准。只有一项评估口服甲基纳曲酮的研究报告了平均住院时间(0.60天,P < 0.05)和术后腹胀(17%对40%,P < 0.05)的显著减少;然而,与治疗组相比,这也是唯一一项报告平均手术时间(38.9 min, P = 0.03)和估计失血量(111.1 mL, P = 0.05)显著增加的研究。在所有报道的研究中,胀气时间、常规饮食、术后阿片类药物消耗和疼痛评分没有显著差异。结论:有限的证据表明任何特定的围手术期排便方案可以减少术后肠道发病率和/或住院时间。口服甲基纳曲酮虽然不是一种孤立的治疗方法,但它可能是标准术后肠道治疗方案的一种安全有效的辅助疗法,并且可能具有更好的患者耐受性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Annals of Medicine and Surgery
Annals of Medicine and Surgery MEDICINE, GENERAL & INTERNAL-
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5.90%
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1665
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