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Journal of Clinical Medicine May 2024Chewing gum, considered a form of sham feeding, has been shown to improve intestinal motor and secretory function in various types of abdominal surgery. We conducted... (Review)
Review
Effects of Postoperative Gum Chewing on Recovery of Gastrointestinal Function Following Laparoscopic Gynecologic Surgery: Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Chewing gum, considered a form of sham feeding, has been shown to improve intestinal motor and secretory function in various types of abdominal surgery. We conducted this systematic review to evaluate the effects of postoperative gum chewing on the recovery of gastrointestinal function after laparoscopic gynecologic surgery. We performed a comprehensive literature review of all randomized controlled trials (RCTs) in PubMed, Embase, and a reference list of relevant studies from the inception to 11 March 2024, comparing postoperative gum chewing versus no gum chewing following laparoscopic gynecologic surgery regardless of indications and setting without language restriction. The primary outcome was the time to the presence of bowel sounds and the time to the first passage of flatus. Cochrane's risk of bias tool was used to assess the risk of bias in included studies. Nine RCTs with a total of 1011 patients were included. Overall, three studies were categorized as having a low risk of bias, three had some concerns, and three exhibited a high risk of bias. The time to the presence of bowel sounds (mean difference [MD] -2.66 h, 95% confidence interval [CI] -3.68 to -1.64, < 0.00001) and time to the first passage of flatus (MD -4.20 h, 95% CI -5.79 to -2.61, < 0.00001) was significantly shorter in the gum-chewing group. There was no statistical difference between the two groups with regard to the time to the first defecation (MD -6.52 h, 95% CI -15.70 to 2.66, = 0.16), time to the first postoperative mobilization (MD 24.05 min, 95% CI -38.16 to 86.26, = 0.45), postoperative ileus (MD 0.68, 95% CI 0.39 to 1.19, = 0.17), and length of hospital stay (MD -0.05 day, 95% CI -0.14 to 0.04, = 0.28). Gum chewing following laparoscopic gynecologic surgery appears to promote the recovery of gastrointestinal function, as evidenced by a reduced time to the presence of bowel sounds and the first passage of flatus.
PubMed: 38792393
DOI: 10.3390/jcm13102851 -
Complementary Therapies in Medicine Jun 2024This study aimed to evaluate the clinical efficacy and safety of probiotics supplementation in the treatment of Parkinson's disease (PD). (Meta-Analysis)
Meta-Analysis
OBJECTIVE
This study aimed to evaluate the clinical efficacy and safety of probiotics supplementation in the treatment of Parkinson's disease (PD).
METHODS
We searched China National Knowledge Infrastructure (CNKI), Weipu (VIP) database, Wanfang Database, Sinomed (CBM), PubMed, Embase, Cochrane library and Web of Science databases for eligible studies from inception to January 4th, 2024. Randomized controlled trials (RCTS) comparing the effects of probiotic supplements and placebo in patients with PD. Meta-analysis was conducted with the software Review Manager 5.4. The quality assessment was performed according to Cochrane risk of bias tool.
RESULTS
A total of 11 RCTs with 756 PD patients were included in this study. We found that probiotics could increase the number of complete bowel movements (CBMs) per week and improved the scores of Patient Assessment of Constipation Quality of Life Questionnaire (PAC-QOL) (SMD = 0.73, 95 % CI: 0.54 to 0.92, P < 0.00001, I = 45 %; SMD = - 0.79, 95 % CI: - 1.19 to - 0.39, P < 0.001, I = 55 %, respectively) compared with the placebo group. However, there was no significant difference between the two groups in improving fecal traits and defecation efforts in PD patients (SMD = 0.87, 95 % CI: 0.01 to 1.74, P = 0.05, I = 94 %; SMD = 1.24, 95 % CI: - 1.58 to 4.06, P > 0.05, I = 98 %, respectively). In terms of PD composite scale scores: after treatment, there was no significant difference in Movement Disorder Society-Unified-Parkinson Disease Rating Scale Ⅲ score (MDS-UPDRSⅢ) between the probiotic group and the placebo group (SMD = - 0.09, 95 % CI: - 0.35 to 0.16, P > 0.05, I = 0 %).
CONCLUSIONS
In conclusion, based on the overall results of the available RCTs studies, our results suggested the potential value of probiotics in improving constipation symptoms in PD patients. Therefore, probiotics may be one of the adjuvant therapy for PD-related constipation patients. The findings of this study provide more proof supporting the effectiveness of probiotics, encouraging probiotics to be utilized alone or in combination with other therapies in clinical practice for PD patients. However, more well-designed RCTs with large sample sizes are required.
Topics: Humans; Constipation; Dietary Supplements; Parkinson Disease; Probiotics; Quality of Life; Randomized Controlled Trials as Topic
PubMed: 38705493
DOI: 10.1016/j.ctim.2024.103045 -
Cureus Oct 2022An anal fissure is a common condition that affects patients of all ages. Its clinical presentation is a sharp pain on defecation with or without blood. It is treated by... (Review)
Review
An anal fissure is a common condition that affects patients of all ages. Its clinical presentation is a sharp pain on defecation with or without blood. It is treated by conservative or surgical means. This study aims to assess the efficacy of a sitz bath as compared to lateral internal sphincterotomy in the treatment of anal fissures. The search strategy used keywords related to the topic of study. Three databases were used: PubMed, Google Scholar, and Science Direct. A total of 551 articles were screened. A quality assessment check was done on the articles leaving 11 articles. Four aspects of sitz bath outcomes were evaluated in the articles. In terms of analgesia, articles showed conflicting evidence. However, the overall evidence supports the use of sitz baths for their analgesic properties. In terms of healing, most articles had similar recovery rates of around 80%. Much of the research supported the use of sitz baths as the primary treatment to heal acute fissures. When compared to lateral internal sphincterotomy, the recovery rates of lateral internal sphincterotomy are superior to those of conservative treatment, including sitz baths. However, studies showed incontinence as a side effect of lateral internal sphincterotomy, and no studies reported side effects from the sitz baths. To conclude, the results of the articles support the use of sitz baths to treat anal fissures. Sitz baths have been found to have analgesic properties, as well as a good healing time. But, compared to lateral internal sphincterotomy, there is a significant difference in the healing rate at the end stage of treatment, lateral internal sphincterotomy is found to be superior. With regards to the side effects, none have been reported from using a sitz bath.
PubMed: 36337820
DOI: 10.7759/cureus.30847 -
Medicine Mar 2021Assessing the effectiveness and safety of acupuncture for chronic constipation in patients with diabetes mellitus is the main purpose of this systematic review protocol.
BACKGROUND
Assessing the effectiveness and safety of acupuncture for chronic constipation in patients with diabetes mellitus is the main purpose of this systematic review protocol.
METHODS
The following electronic databases will be searched from their respective inception dates to December 1st 2020: PubMed, the Cochrane Library, Embase, World Science Net, the Allied and Complementary Medicine Database, the Web of Science, China National Knowledge Infrastructure, the Chongqing VIP Chinese Science and Technology Periodical Database and the Wanfang Database. All published randomized controlled trials in English or Chinese related to acupuncture for constipation in patient with diabetes mellitus will be included. The Bristol stool scale, spontaneous complete bowel movements, and observing symptoms (yes/no) including defecation feeling, defecation weakness, feeling of incomplete evacuation, bloating, and flatulence were considered as primary measures. The treatment efficiency consideration according to Bristol stool scale was considered as secondary measure. Two reviewers will conduct the study selection, data extraction and assessment independently. The assessment of risk of bias and data synthesis will be conducted with Review Manager Software (RevMan) V.5.2.
RESULTS
The results will provide a high-quality synthesis of current evidence for researchers in this subject area.
CONCLUSION
The conclusion of our study will provide an evidence to judge whether.Acupuncture is an effective intervention for chronic constipation in patients with diabetes mellitus.
ETHICS AND DISSEMINATION
Formal ethical approval is not necessary as the data cannot be individualized. The results of this protocol will be disseminated in a peer-reviewed journal or presented at relevant conferences.
PROSPERO REGISTRATION NUMBER
INPLASY202110079.
Topics: Acupuncture Therapy; Chronic Disease; Constipation; Diabetes Mellitus; Humans; Quality of Life
PubMed: 33655948
DOI: 10.1097/MD.0000000000024886 -
Neural Plasticity 2020ective. To evaluate the clinical effectiveness and safety of acupuncture therapy in the treatment of diarrhea-predominant irritable bowel syndrome (IBS-D) or functional... (Meta-Analysis)
Meta-Analysis
ective. To evaluate the clinical effectiveness and safety of acupuncture therapy in the treatment of diarrhea-predominant irritable bowel syndrome (IBS-D) or functional diarrhea (FD) in adults. Five electronic databases-PubMed, EMBASE, CNKI, VIP, and Wanfang-were searched, respectively, until June 8, 2020. The literature of clinical randomized controlled trials of acupuncture for the treatment of IBS-D or FD in adults were collected. Meta-analysis was conducted by Using Stata 16.0 software, the quality of the included studies was assessed by the RevMan ROB summary and graph, and the results were graded by GRADE. . Thirty-one studies with 3234 patients were included. Most of the studies were evaluated as low risk of bias related to selection bias, attrition bias, and reporting bias. Nevertheless, seven studies showed the high risk of bias due to incomplete outcome data. GRADE's assessments were either moderate certainty or low certainty. Compared with loperamide, acupuncture showed more effectiveness in weekly defecation (SMD = -0.29, 95% CI [-0.49, -0.08]), but no significant improvement in the result of the Bristol stool form (SMD = -0.28, 95% CI [-0.68, 0.12]). In terms of the drop-off rate, although the acupuncture group was higher than the bacillus licheniformis plus beanxit group (RR = 2.57, 95% CI [0.24, 27.65]), loperamide group (RR = 1.11, 95% CI [0.57, 2.15]), and trimebutine maleate group (RR = 1.19, 95% CI [0.31, 4.53]), respectively, it was lower than the dicetel group (RR = 0.83, 95% CI [0.56, 1.23]) and affected the overall trend (RR = 0.93, 95% CI [0.67, 1.29]). Besides, acupuncture produced more significant effect than dicetel related to the total symptom score (SMD = -1.17, 95% CI [-1.42, -0.93]), IBS quality of life (SMD = 2.37, 95% CI [1.94, 2.80]), recurrence rate (RR = 0.43, 95% CI [0.28, 0.66]), and IBS Symptom Severity Scale (SMD = -0.75, 95% CI [-1.04, -0.47]). Compared to dicetel (RR = 1.25, 95% CI [1.18, 1.32]) and trimebutine maleate (RR = 1.35, 95% CI [1.13, 1.61]), acupuncture also showed more effective at total efficiency. The more adverse effect occurred in the acupuncture group when comparing with the dicetel group (RR = 11.86, 95% CI [1.58, 89.07]) and loperamide group (RR = 4.42, 95% CI [0.57, 33.97]), but most of the adverse reactions were mild hypodermic hemorrhage. Acupuncture treatment can improve the clinical effectiveness of IBS-D or FD, with great safety, but the above conclusions need to be further verified through the higher quality of evidence.
Topics: Acupuncture Therapy; Adult; Diarrhea; Humans; Irritable Bowel Syndrome; Quality of Life; Treatment Outcome
PubMed: 33299403
DOI: 10.1155/2020/8892184 -
International Wound Journal Apr 2020To evaluate the efficacy of intravenous lidocaine in relieving postoperative pain and promoting rehabilitation in laparoscopic colorectal surgery, we conducted this... (Meta-Analysis)
Meta-Analysis
To evaluate the efficacy of intravenous lidocaine in relieving postoperative pain and promoting rehabilitation in laparoscopic colorectal surgery, we conducted this meta-analysis. The systematic search strategy was performed on PubMed, EMBASE, Chinese databases, and Cochrane Library before September 2019. As a result, 10 randomised clinical trials were included in this meta-analysis (n = 527 patients). Intravenous lidocaine significantly reduced pain scores at 2, 4, 12, 24, and 48 hours on movement and 2, 4, and 12 hours on resting-state and reduced opioid requirement in first 24 hours postoperatively (weighted mean difference [WMD] = -5.02 [-9.34, -0.70]; P = .02). It also decreased the first flatus time (WMD: -10.15 [-11.20, -9.10]; P < .00001), first defecation time (WMD: -10.27 [-17.62, -2.92]; P = .006), length of hospital stay (WMD: -1.05 [-1.89, -0.21]; P = .01), and reduced the incidence of postoperative nausea and vomiting (risk ratio: 0.53 [0.30, 0.93]; P = .03) when compared with control group. However, it had no effect on pain scores at 24 and 48 hours at rest, the normal dietary time, and the level of serum C-reactive protein. In summary, perioperative intravenous lidocaine could alleviate acute pain, reduce postoperative analgesic requirements, and accelerate recovery of gastrointestinal function in patients undergoing laparoscopic colorectal surgery.
Topics: Administration, Intravenous; Anesthetics, Local; Colorectal Surgery; Humans; Laparoscopy; Lidocaine; Pain Measurement; Pain, Postoperative; Recovery of Function
PubMed: 31837112
DOI: 10.1111/iwj.13279 -
Digestive Surgery 2020Postoperative ileus prolongs both hospital stay and patients' morbidity, having at the same time a great impact on health care costs. Coffee, a worldwide popular, cheap... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Postoperative ileus prolongs both hospital stay and patients' morbidity, having at the same time a great impact on health care costs. Coffee, a worldwide popular, cheap beverage might have an important effect on the motility of the postoperative bowel.
METHODS
PubMed, Scopus, and Cochrane Central Register of Controlled Trials were systematically searched.
RESULTS
Four studies met the inclusion criteria of our meta-analysis. A total of 341 patients were included. The postoperative administration of coffee significantly reduces the time to first bowel movement, the time to first flatus and the time to tolerance of solid diet. Safe conclusions could not be drawn regarding the additional use of laxatives, the necessity for reinsertion of nasogastric tube or the need for reoperation as all the aforementioned outcomes did not present any statistically significance. None of the complications were attributed to the administration of coffee.
CONCLUSION
The administration of coffee as a postoperative ileus prevention measure can change the way postoperative enhanced recovery is applied. Even though the mechanism of action of coffee is not fully known, currently available literature demonstrates a significant improvement in gastrointestinal motility without having any impact on postoperative morbidity. Studies with higher methodological quality can offer a more careful evaluation of the clinical use of this popular beverage.
Topics: Caffeine; Coffee; Defecation; Digestive System Surgical Procedures; Gastrointestinal Motility; Gynecologic Surgical Procedures; Humans; Intestinal Pseudo-Obstruction; Intestines; Length of Stay; Phytotherapy; Recovery of Function; Time Factors
PubMed: 30636241
DOI: 10.1159/000496431 -
Medicine Sep 2023This systematic review and meta-analysis aimed to evaluate the efficacy of transcutaneous electronic acupoint stimulation (TEAS) for improving postoperative recovery... (Meta-Analysis)
Meta-Analysis
BACKGROUND
This systematic review and meta-analysis aimed to evaluate the efficacy of transcutaneous electronic acupoint stimulation (TEAS) for improving postoperative recovery after gynecologic surgery.
METHODS
We performed a thorough search of 6 databases until March 2023, identifying 12 randomized controlled trials that met our predefined inclusion criteria and encompassed a total of 1510 patients. For continuous outcomes, we calculated the weighted mean difference (WMD), and for binomial outcomes, we used the risk ratio (RR). We evaluated heterogeneity among the included studies using Cochran I2 and Q statistics, utilizing a random-effects model when the I2 value exceeded 50%. To assess publication bias, we employed Egger test.
RESULTS
Our analysis found that TEAS significantly reduced the risk of postoperative nausea (RR: 0.60, 95% CI: 0.43-0.83, P = .002) and postoperative vomiting (RR: 0.54, 95% CI: 0.43-0.67, P < .001), visual analogue scale (WMD: -0.47, 95% CI: -0.76 to -0.17, P = .002), as well as shortened the time to first bowel movement (WMD: -18.43, 95% CI: -20.87 to -15.99, P < .001) and time to first flatus (WMD: -8.98, 95% CI: -12.46 to -5.51, P < .001) compared to the conventional group.
CONCLUSIONS
Our findings suggested that TEAS may improve postoperative recovery following gynecologic surgery. However, to confirm these results, larger randomized controlled trials encompassing a more diverse range of patient populations are urgently required.
Topics: Female; Humans; Acupuncture Points; Gynecologic Surgical Procedures; Databases, Factual; Defecation; Postoperative Nausea and Vomiting; Electronics
PubMed: 37657060
DOI: 10.1097/MD.0000000000034834 -
World Journal of Surgical Oncology Jun 2020Enhanced recovery after surgery (ERAS) protocol has been identified to be beneficial in the amount of operations such as gastrointestinal surgery. However, the efficacy... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Enhanced recovery after surgery (ERAS) protocol has been identified to be beneficial in the amount of operations such as gastrointestinal surgery. However, the efficacy and safety in robot-assisted laparoscopic prostatectomy/laparoscopic radical prostatectomy (RALP/LRP) still remain controversial.
METHOD
We searched randomized controlled trials and retrospective cohort studies comparing ERAS versus conventional care for prostate cancer patients who have undergone RALP/LRP. ERAS-related data were extracted, and quality of included studies was assessed using the Newcastle-Ottawa quality assessment scale and the Jadad scale.
RESULT
As a result, seven trials containing 784 prostate cancer patients were included. ERAS was observed to be significantly associated with shorter length of hospital stay (SMD - 2.55, 95%CI - 3.32 to - 1.78, P < 0.05), shorter time to flatus (SMD - 1.55, 95%CI - 2.26 to - 0.84, P < 0.05), shorter time to ambulate (SMD - 6.50, 95%CI - 10.91 to - 2.09, P < 0.05), shorter time to defecate (SMD - 2.80, 95%CI - 4.56 to - 1.04, P < 0.05), and shorter time to remove drainage tube (SMD - 2.72, 95%CI - 5.31 to - 0.12, P < 0.05). Otherwise, no significant difference was reported in other measurements.
CONCLUSIONS
In conclusion, ERAS can reduce length of hospital stay, time to flatus, time to defecate, time to ambulate, and time to remove drainage tube in prostate cancer patients who have undergone RALP/LRP compared with conventional care.
Topics: Enhanced Recovery After Surgery; Humans; Laparoscopy; Length of Stay; Male; Prognosis; Prostatectomy; Prostatic Neoplasms; Robotic Surgical Procedures; Treatment Outcome
PubMed: 32552894
DOI: 10.1186/s12957-020-01897-6 -
Annals of Palliative Medicine Apr 2021Moxibustion is widely used in the recovery of gastrointestinal function in East Asian countries, especially in China. This systematic review aims to evaluate the... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Moxibustion is widely used in the recovery of gastrointestinal function in East Asian countries, especially in China. This systematic review aims to evaluate the recovery effects of moxibustion on gastrointestinal function in preventing early postoperative small-bowel obstruction (EPSBO).
METHODS
The Medline, Embase, PubMed, and the other seven databases were searched independently by two authors. Randomized controlled trials (RCTs) were selected using the PICOS method. The methodological quality was appraised with the Cochrane's risk of bias tool, and the reporting quality of included studies was evaluated by Consolidated Standards of Reporting Trials (CONSORT) and STandards for Reporting Interventions in Clinical Trials of Moxibustion (STRICTOM), respectively. Revman 5.2.0 was used for statistical analysis, and the mean difference (MD) with 95% confidence interval (CI) was performed for effect estimation. Random effects model (REM) and fixed effects model (FEM) were used for pooling data.
RESULTS
A total of 8 RCTs with 693 participants were included. Meta-analysis showed that moxibustion combined with usual care had favorable effects on the time to first flatus (MD -15.15 h, 95% CI: -19.14 to -11.15, 8 studies, I2=85%, P<0.00001, REM), the time to bowel sound recovery (MD -10.35 h, 95% CI: -11.65 to -9.06, 7 studies, I2=0%, P=0.91, FEM), the time to first defecation (MD -18.94 h, 95% CI: -24.53 to -13.36, 3 studies, I2=45%, P=0.16, FEM), and the duration time to abdominal distention (MD -11.7 h, 95% CI: -15.32 to -8.09, 3 studies, I2=0%, P=0.70, FEM) when compared to the controls. No adverse events were reported in the included studies.
CONCLUSIONS
Moxibustion may have a beneficial effect on the recovery of gastrointestinal function in preventing EPSBO. However, positive findings should be treated carefully. And rigorous studies with high quality and large samples are warranted.
Topics: China; Humans; Moxibustion; Postoperative Complications; Recovery of Function
PubMed: 33691449
DOI: 10.21037/apm-20-1266