Background Adhesive small bowel obstructions are the most common postoperative causes of hospitalization. Several studies investigated the diagnostic and therapeutic role of water-soluble contrast agent (WSCA) in predicting the need for surgery, but there is no consensus. Methods A systematic review and meta-analysis was done of studies on diagnostic and therapeutic role of oral WSCA. Results WSCA had a sensitivity of 92% and a specificity of 93% in predicting resolution of obstruction without surgery; diagnostic accuracy increased significantly if abdominal X-rays were taken after 8 hours. The administration of oral WSCA reduced the need for surgery (odds ratio.55, P =.003), length of stay (weighted mean difference -2.18 days, P <.00001), and time to resolution (weighted mean difference -28.25 hours, P <.00001). No differences in terms of morbidity or mortality were recorded. Conclusions The administration of WSCA is accurate in predicting the need for surgery; the test should be taken after at least 8 hours from administration. WSCA is a proven safe and effective treatment, correlated with a significant reduction in the need for surgery and in the length of hospital stay.
Ceresoli, M., Coccolini, F., Catena, F., Montori, G., Di Saverio, S., Sartelli, M., et al. (2016). Water-soluble contrast agent in adhesive small bowel obstruction: A systematic review and meta-analysis of diagnostic and therapeutic value. THE AMERICAN JOURNAL OF SURGERY, 211(6), 1114-1125 [10.1016/j.amjsurg.2015.06.012].
Water-soluble contrast agent in adhesive small bowel obstruction: A systematic review and meta-analysis of diagnostic and therapeutic value
Marco Ceresoli
Primo
;Luca Ansaloni
2016
Abstract
Background Adhesive small bowel obstructions are the most common postoperative causes of hospitalization. Several studies investigated the diagnostic and therapeutic role of water-soluble contrast agent (WSCA) in predicting the need for surgery, but there is no consensus. Methods A systematic review and meta-analysis was done of studies on diagnostic and therapeutic role of oral WSCA. Results WSCA had a sensitivity of 92% and a specificity of 93% in predicting resolution of obstruction without surgery; diagnostic accuracy increased significantly if abdominal X-rays were taken after 8 hours. The administration of oral WSCA reduced the need for surgery (odds ratio.55, P =.003), length of stay (weighted mean difference -2.18 days, P <.00001), and time to resolution (weighted mean difference -28.25 hours, P <.00001). No differences in terms of morbidity or mortality were recorded. Conclusions The administration of WSCA is accurate in predicting the need for surgery; the test should be taken after at least 8 hours from administration. WSCA is a proven safe and effective treatment, correlated with a significant reduction in the need for surgery and in the length of hospital stay.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.