Time Of First Defecation Research Articles

Effect of Acupoint Stimulation on Improving Gastrointestinal Motility in Patients After Gastrectomy: A Systematic Review and Meta-Analysis.

Introduction: Gastrointestinal immobility is experienced by many patients who undergo gastric surgery. This complication delays enteral nutrition, prolongs hospitalization, and causes discomfort. Acupoint stimulation is a popular alternative nonpharmacological treatment for gastrointestinal immobility. This study aimed to explore the effects of acupoint stimulation on gastrointestinal immobility after gastrectomy. Design: Systematic review and meta-analysis. Methods: Databases (PubMed, Cochrane, Joanna Briggs Institute EBP Database, Medline, CINAHL Complete, and Airiti library) were searched from their inception to April 2022 for relevant articles. Articles in Chinese and English were included, without limitations on year, region, or country. The inclusion criteria were studies with participants >18 years of age, postgastric surgery, and hospitalization. In addition, randomized controlled trials (RCTs) were included. Data were analyzed using random effects models, and data heterogeneity was investigated using subgroup analysis. Meta-analysis was performed using Review Manager 5.4 software. Results: We included 785 participants from six studies. Invasive and noninvasive acupoint stimulation reduced the time of gastrointestinal mobility better than usual care. In the control group, the time of first flatus was 43.56 ± 9.57 h to 108 ± 19.2 h, and the time of first defecation was 77.27 ± 22.67 h to 139.2 ± 24 h. In the experimental group, the time of first flatus and defecation was 36.58 ± 10.75 h to 79.97 ± 37.31 h and 70.56 ± 15.36 h to 108.55 ± 10.75 h, respectively. Subgroup analysis showed that invasive acupoint stimulation with acupuncture reduced the time of first flatus and defecation to 15.03 h (95% confidence interval [CI] = -31.06 to 1.01) and 14.12 h (95% CI = -32.78 to 4.54), respectively. Noninvasive acupoint stimulation, including acupressure and transcutaneous electrical acupoint stimulation (TEAS), reduced the time of first flatus and defecation to 12.33 h and (95% CI = -20.59 to -4.06) and 12.20 h (95% CI = -24.92 to 0.52), respectively. Conclusions: Acupoint stimulation improved the gastrointestinal immobility of postgastrectomy. In the included RCT articles, invasive and noninvasive stimulations were effective. However, noninvasive acupoint stimulation, such as with TEAS and acupressure, was more efficient and convenient than invasive stimulation. Overall, health care professionals with adequate training or under the supervision of an acupuncturist can effectively perform acupoint stimulation to improve the quality of postgastrectomy care. They can select commonly used and effective acupoints to enhance gastrointestinal motility. Clinical relevance: Acupoint stimulation, such as acupressure, electrical acupoint stimulation, or acupuncture, can be included in postgastrectomy routine care to improve gastrointestinal motility and reduce abdominal discomfort.

Efficacy analysis of enhanced recovery after surgery in laparoscopic-assisted radical resection of type I choledochal cyst.

The objective of this study was to investigate the feasibility and effectiveness of laparoscopic-assisted radical resection of type I choledochal cyst (CC) guided by the principles of enhanced recovery after surgery (ERAS). A retrospective cohort study of type I CC admitted to our hospital between May 2020 and December 2021 were analyzed, a total of 41 patients with choledochal cyst underwent surgery during this period and 30 cases were selected based on inclusion and exclusion criteria. Patients (n = 15) who received the traditional treatment from May 2020 to March 2021 were included in the traditional group. Patients (n = 15) who received ERAS from April 2021 to December 2021 were included in the ERAS group. Both groups underwent surgery performed by the same surgical team. Preoperative data of the two groups were recorded, and relevant data were statistically analyzed and compared. There was a statistically significant difference in the dose of opioids. Significant differences were observed between the ERAS and traditional groups in the results of the FLACC pain assessment scale on the 1st and 2nd day after surgery, time of gastric tube, urinary catheter and abdominal drainage tube removal, time of first defecation after operation, time of first eating after operation, time to reach full food intake, results of CRP, ALB, and ALT on the 3rd and 7th postoperative day, postoperative hospital stay, and total treatment cost. No significant differences were observed between the two groups in terms of gender, age, body weight, cyst size, preoperative CRP, ALB, ALT, intraoperative blood loss, operation time, and the number of cases converted to laparotomy. Neither the FLACC pain assessment scale on the 3rd day after surgery, the incidence of postoperative complications, nor the rate of readmission within 30 days showed significant differences. Laparoscopic-assisted radical resection of type I CC guided by the principles of ERAS is safe and effective for children. The ERAS concept demonstrated advantages over traditional laparoscopic surgery, including reduced opioid use, shorter time to first postoperative defecation, earlier resumption of postoperative feeding, shorter time to reach full feeding, shorter postoperative hospital stay, and lower total treatment cost.

Sequential Enteral and Parenteral Nutrition Support Assisted by Nutritional Risk Screening Improves Outcome in the Colorectal Cancer Patients Undergoing Radical Surgery

We have examined the influence of sequential enteral and parenteral nutrition support, assisted by nutritional risk screening, on colorectal cancer patients undergoing radical surgery. This cohort included 100 colorectal cancer patients receiving radical surgery in Zhejiang Quzhou People’s Hospital between May 2021 and April 2022. The control group received treat¬ment with early enteral nutrition support only. The experimental group, however, received sequential enteral and parenteral nutrition support, assisted by nutritional risk screening. The indicators of nutrition adequacy, gastrointestinal function, early postoperative complications, and quality of life were compared. The albumin, hemoglobin, and albumin levels presented no difference between the two groups before treatment. After treatment, these indicators in the experimental group were elevated relative to those in the control group. The time of bowel sound recovery, the time of first anal exhaustion, time of first defecation, and the incidence of surgical complications in the experimental group decreased relative to those in the control group. A 36-item short-form health survey showed an elevation in the experimental group relative to the control group. Application of sequential enteral and parenteral nutritional support assisted by nutritional risk screening in colorectal cancer patients has a significant effect, which helps improve postoperative nutritional status, facilitate gastrointestinal function recovery, reduce incidence of complications, and accelerate postoperative recovery.

Effects of the Concept of Fast-Track Surgery Combined with Empathic Nursing on Perioperative Complication Prevention and Postoperative Recovery of Gynecological Malignant Tumor Patients.

Objective This study is aimed at exploring the effects of the concept of fast-track surgery (FTS) combined with empathic nursing on perioperative complication prevention and postoperative recovery of gynecological malignant tumor patients. Methods A total of 180 patients with gynecological malignant tumor treated by surgery in our hospital from September 2018 to October 2021 were randomly divided into three groups: group A, group B, and group C, with 60 patients in each group. Group C was given conventional nursing intervention, group B was given FTS intervention, and group A was given FTS intervention combined with empathic care. Psychological stress state (systolic blood pressure, diastolic blood pressure, and heart rate), postoperative recovery indicators (time of first anal exhaust, time of first defecation, time of getting out of bed, and length of postoperative hospital stay), postoperative complications, and psychological state (Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS)) levels of patients in the three groups were compared. Results Systolic blood pressure, diastolic blood pressure, and heart rate in group A were lower than those in group B, and those in group B were lower than those in group C (all P < 0.05). The time of first anal exhaust, time of first defecation, time of getting out of bed, and postoperative hospital stay in groups A and B were shorter than those in group C (all P < 0.05).The incidence of postoperative complications in groups A and B was 8.33% and 8.33%, respectively, lower than 23.33% in group C (both P < 0.05). SAS and SDS scores of group A were lower than those of groups B and C after intervention (all P < 0.05). Conclusion The concept of FTS combined with empathic nursing is beneficial to reduce the stress response of patients with gynecological malignant tumor before surgery, reduce the risk of postoperative complications, improve patients' mood, and speed up the rehabilitation process of patients.

Effects of preoperative walking on bowel function recovery for patients undergoing gynecological malignancy laparoscopy

AbstractTo investigate effects of preoperative walking on bowel function recovery for patients after gynecological malignancy laparoscopy. The 156 patients with gynecoligical cancers after laparoscopy in Jiangsu from June 2020 to September 2021 were selected as research subjects, who were randomized into an experimental group (n = 78) and a control group (n = 78). Both of the groups received routine nursing care during the study. In addition, the experimental group underwent low‐moderate intensity walking exercise 1 week before surgery. The bowel function (including the time of first defecation, the time of first passage of flatus/”gas‐out time” and the recovery time of bowel sound), adverse events (nausea, vomiting abdominal distension and abdominal pain), as well as postoperative complications (ileus symptoms, deep venous thrombosis, infections and etc.), were measured daily. The time of first defecation, the time of first passage of flatus and the recovery time of bowel sound in experimental group were less than the control group after treatment (p &lt; .05). Repeated measures analysis of variance showed that the adverse reactions (nausea, vomiting, abdominal distension, abdominal pain, and ileus symptoms) of the experimental group were weaker than those of the control group at different time points after the intervention (p &lt; .05). Walking before surgery can effectively promote the recovery of bowel function and reduce the adverse reactions, as well as the risk of ileus related to gynecological malignancy laparoscopy.

Effects of Laparoscopic versus Open Surgery for Advanced Gastric Cancer after Neoadjuvant Chemotherapy: A Meta-Analysis.

To evaluate the efficacy of laparoscopy and laparotomy after neoadjuvant chemotherapy in the treatment of advanced gastric cancer by meta-analysis. Cochrane Library, Embase, and PubMed were searched by computer until December 1, 2021. Literature was screened according to inclusion and exclusion criteria, and relevant data were extracted for meta-analysis using RevMan 5.3. A total of 1027 patients from 11 literature studies were included in this study, including 413 patients in the laparoscopic group and 614 patients in the open group. Meta-analysis showed that the laparoscopic group had less intraoperative bleeding (SMD = -1.11; 95% CI: -1.75-0.47; P=0.0006), early postoperative exhaust (SMD = -0.45; 95% CI: -0.70-0.20; P=0.0004), and shorter postoperative hospital stay (SMD = 0.97; 95% CI: 1.69∼0.26; P=0.008), but had longer the operation time (SMD = 0.65; 95% CI: 0.52∼0.79; P < 0.00001). There was no significant difference in the number of lymph nodes dissected during operation (SMD = -0.45; 95% CI: -0.42-0.19; P=0.45), the incidence of surgical complications 30 days after operation (OR = 0.78; 95% CI: 0.53∼1.13; P=0.19), time of first defecation (MD = 0.00; 95% CI: -0.10∼0.10; P=0.98), and time of first postoperative feeding (MD = -0.05; 95% CI: -0.22∼0.12; P=0.54) between the two groups. For long-term prognosis, there was no significant difference in the 3-year overall survival rate after operation between the two groups (RR = 0.84; 95% CI: 0.63-1.12; P=0.23). Compared with the open stomach cancer surgery, laparoscopic gastric cancer surgery has less intraoperative blood loss, shorter hospitalization time, and advantages such as early rehabilitation, postoperative complications rate, and long-term survival, which confirmed the validity and security of the laparoscopic surgery.

Meta-analysis of acupuncture and moxibustion for the therapeutic effect on postoperative gastrointestinal dysfunction of gastric cancer

To systematically review the therapeutic effect of acupuncture and moxibustion on postoperative gastrointestinal dysfunction (GID) of gastric cancer with meta-analysis. The articles of randomized controlled trials (RCTs) of acupuncture and moxibustion treatment for postoperative GID of gastric cancer were retrieved from the following databases from the time of database establishment to December 31, 2020, including PubMed, EMbase, Cochrane Central Register of Controlled Trials (CENTRAL), China National Knowledge Infrastructure (CNKI), Wanfang database, VIP database and China Biomedical Literature Database (SinoMed). RevMan5.3 software was used for meta-analysis. Using Stata16.0 software, sensitivity analysis and publication bias test were performed. A total of 16 RCTs were included finally, including 1 360 patients, of which, there were 681 cases in the intervention group and 679 cases in the control group. Meta-analysis results showed that acupuncture and moxibustion shortened the time of first flatus (P<0.000 01, MD =-14.52, 95%CI = [-17.31, -11.74]), the time of first bowel sound (P<0.000 01, MD =-10.50, 95%CI =[-13.99, -7.01]) and the time of first defecation (P<0.000 1, MD =-13.79, 95%CI =[-20.09, -7.50]). Meanwhile, acupuncture and moxibustion shortened the time of the first food intake (P<0.000 1, MD =-3.23, 95%CI = [-3.45, -3.00]) and the hospital stay (P<0.000 01, MD =-1.94, 95%CI =[-2.20, -1.69]) after gastric cancer operation, and reduced the incidences of postoperative adverse reactions, i.e. nausea and vomiting (P =0.000 3, RR =0.43, 95%CI =[0.28, 0.68]) and abdominal distention (P =0.000 5, RR =0.41, 95%CI =[0.25, 0.68]). Acupuncture and moxibustion can promote the recovery of postoperative gastrointestinal function in the patients with gastric cancer. But, for the comparison among different measures of acupuncture and moxibustion intervention, it needs more high-quality trials for a further verification.

Comparison of Haemorrhoidectomy Using Ligasure with Open (Milligan Morgan Haemorrhoidectomy)

Aim: To compare between haemorrhoidectomy using ligasure versus conventional haemorrhoidectomy in terms of operative time, bleeding and post-operative pain. Study design: Controlled randomized trial Place and duration of study: Department of Surgery, DHQ Hospital Abbottabad from 1stJuly 2018 to 31stDecember 2020 Methodology: One hundred and twenty patients were enrolled. Patients were allocated to two groups and haemorrhoidectomy done with ligasure (LS, group A) and conventional method i.e. Milligan Morgan haemorrhoidectomy (MMH, group B) and each group comprised 60 patients. In group A pedicals were coagulated with the ligasure rather than transfixed as in group B (MMH). Operative time and per operative bleeding recorded during surgery while postop pain score recorded using visual analogue score (0-10) especially during first defecation. Results: The mean age of 46±16.36 years were studied and 79.1% were males. In group A 72.5% patients were males and 27.5% females compared to 67.5% males and 32.5% females in group B. 87.5% of patients had 3rd degree hemorrhoids in group A while 89.4% had the same disease in group B. Operative time was between 20-35 minute in group A compared to 10-30minutes in group B. In group A 75% observed mild pain as recorded on VAS, 25% had moderate pain at time of first defecation while in group B 69.4% patients had moderate pain on VAS, 25.6% experienced mild pain and another 5% reported severe pain during defecation. Mean blood loss was 104.21±41.45 ml in both populations, in group A it was 83.59±34.34 ml while in group B it was 124.84±37.56 ml. Mean VAS of both populations was 3.55±2.05 while mean time of operation was 36.35±7.22.Using independent sample T test, there was statistically significant (P=0.000) difference on all three parameters between two groups. Conclusions: Haemorrhoidectomy using ligasure is safe and causes minimal bleeding, requires less operative time and is associated with less pain compared with conventional scissors dissection, and is a good alternative to diathermy excision. Keywords: Haemorrhoidectomy, Ligasure (LS), Conventional haemorrhoidectomy

Laparoscopic vs open Ladd\u2019s procedure for malrotation in neonates and infants: a propensity score matching analysis

BackgroundLaparoscopic Ladd’s procedure for malrotation in children is still a controversial approach. Although some retrospective studies have compared the outcomes of the two types of procedure with inconsistency outcomes. Currently, there are few large-scale studies on laparoscopic treatment in malrotation with neonates and infants. We did a study based on propensity score matching to compare the effects of the two kinds of approach in neonates and infants. To investigate the therapeutic effect of laparoscopy and open Ladd’s procedure by the propensity score-matching (PSM) to enhance the validity of the comparison.MethodsA total series of 143 cases of intestinal malrotation without intestinal necrosis was included in the study during the 8 years from January 2012 to January 2020, including 68 cases of open Ladd’s procedure and 75 cases of laparoscopic Ladd’s procedure including five cases of transfer laparotomy. By a propensity score 1:1 matching, 62 patients were stratified for each group.Results and conclusionThere was no significant difference in volvulus degree, weight and gender between the two groups (p > 0.05). Laparoscopic surgery took more time than open surgery (105.9 min vs 70.6 min, p < 0.05), but it had less hospital stay (12.4 days vs 14.6 days, p < 0.05) or less incision infection (0 vs 6, p < 0.05). There was no significant difference between the two groups at the time of first defecation, blood loss, time of full feeding and reoperation (p > 0.05). The cosmetic effect of laparoscopic surgery is better than that of open surgery. Laparoscopic Ladd’s procedure is a safe approach. It can reduce the length of hospital stay and incision infection, but the operation time was extended, the other complications are similar compared with open procedure for intestinal malrotation in neonates and infants.

Application Value of Moxibustion Combined with Acupoint Application in Patients with Abdominal Distension after Gynecological Surgery

Objective: To explore the application value of moxibustion and acupoint application in the treatment of postoperative abdominal distention in patients undergoing gynecological surgery. Methods: Seventy-two patients who underwent gynecological surgery in our hospital from May 2020 to May 2021 were randomly divided into two groups. Group A was treated with moxibustion and acupoint application, and group B was treated with routine treatment. The incidence of postoperative abdominal distention, therapeutic effect of abdominal distention, defecation time, exhaust time, recovery time of bowel sounds and the changes of patients’ quality of life were analyzed. Results: The incidence of abdominal distension in group A was 22.22%, which was lower than 41.47% in group B (P &lt; 0.05). The therapeutic effect of abdominal distension in group A was 87.50%, which was higher than 66.67% in group B (P &lt; 0.05). The recovery time of first defecation, first exhaust and bowel sound in group A was shorter than that in group B (P &lt; 0.05). All postoperative quality of life scores of group A were higher than that of group B (P &lt; 0.05). Conclusion: On the basis of routine postoperative intervention, moxibustion and acupoint application can reduce the risk of postoperative abdominal distention, reduce the degree of abdominal distention, promote the recovery of intestinal function, shorten the first postoperative exhaust and defecation time, and then improve the quality of life of patients.

Effect of Systematic Holistic Nursing Combined with the MDT Teaching Method in the Nursing of Neonatal Jaundice and Its Impact on the Recovery of the Newborns' Physiological Function.

The application effect of systematic holistic nursing combined with the multidisciplinary team (MDT) in the nursing of neonatal jaundice was explored. This study was a retrospective control study. 90 cases of neonatal jaundice admitted to our hospital (February 2020–February 2021) were equally split into group P treated with routine nursing and group Q treated with systematic holistic nursing combined with MDT. The application effect of the two nursing programs was compared and analyzed. Groups P and Q showed no statistical difference in general data (P > 0.05). Compared with group P, the jaundice regression time, hospitalization time, time of first defecation, and time of meconium turning yellow of group Q were notably shorter, and the body weight and total treatment efficiency of group Q were notably higher (P < 0.05). From the third day, the daily jaundice indexes between the two groups were different; that is, the indexes of group Q were notably lower compared with group P (P < 0.05). The scores of environmental nursing, special nursing, basic nursing, and service attitude in group Q were notably higher compared with group P (P < 0.05). In the nursing process of neonatal jaundice, the combination of systematic holistic nursing and MDT can effectively shorten the time of first defecation and meconium turning yellow, reduce jaundice indexes, promote the recovery of the physiological function, and improve the clinical efficacy and nursing quality.

Influencing Factors of Gastrointestinal Function Recovery after Gastrointestinal Malignant Tumor.

Gastric cancer is a malignant tumor with a high incidence in the world, and the incidence rate only increases every year. Because of the loss of mental property caused by surgery and postoperative recovery treatment, it has become a difficult problem for many families to solve. Exploring the factors affecting the recovery of gastrointestinal function after surgery to accelerate the recovery has become one of the important research topics of current medical experts and scholars. The purpose of this article is to explore the factors affecting the recovery of gastrointestinal function after gastrointestinal malignancies. In this paper, firstly through experimental investigation, the fasting time and operation method of patients undergoing gastrointestinal malignant tumor surgery are used as variables to conduct a controlled experiment, and the first defecation time, exhaust time, and bowel sound recovery of the experimental subjects after surgery are recorded. Changes in time and other indicators are compared to verify whether they affect the recovery of gastrointestinal function. Experimental data showed that the recovery time of bowel sounds was 29.10 ± 11.09 h in patients with fasting time less than or equal to 2 days after operation, the time of first exhaustion was 28.75 ± 27.80 h, and the time of first defecation was 54.70 ± 39.40 h. The recovery time of bowel sounds in patients with fasting time longer than 2 days was 40.47 ± 9.40 h, the first exhaust time was 71.40 ± 17.54 h, and the first defecation time was 98.30 ± 28.16 h. Therefore, resuming diet as soon as possible after operation is beneficial to the recovery of gastrointestinal function in patients with gastrointestinal malignancies.

Effectiveness of acupuncture for the recovery of gastrointestinal function of patients with gastric cancer in the postoperative period: A protocol for systematic review and meta-analysis.

Background:Gastric cancer (GC) is the most common malignant tumors in the world and surgical resection remains the primary treatment for it. Postoperative patients often suffer from gastrointestinal dysfunction as the most common side effects of surgery for GC patients. Acupuncture has a regulatory effect on gastrointestinal function. We conducted this study to assess the effectiveness of acupuncture on the restoration of gastrointestinal function of postoperative patients with GC.Methods:Seven electronic databases will be searched from inception to November 2020 to identify any relevant study: Medline, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), China National Knowledge Infrastructure (CNKI), Wanfang Database, Chinese Biomedical Literature Database (CBM), and Chinese Scientific Journal Database (VIP database). No restriction on time and language. The primary outcome measure will be the Time to First Flatus and secondary outcome measures include the time of first defecation and the quality of life (QOL) and the number of patients with abdominal distention. We will use EndNote V.9.1 to screen the eligible literature and the I2 statistic to assess heterogeneity in the included studies. The meta-analysis will be conducted using the Review Manager (RevMan) software (V.5.3).Results:Our study aims to systematically assess whether the pooled effects of currently available trials prove effects of acupuncture in improving gastrointestinal function of patients with GC in the postoperative period.Conclusion:This study will conduct an evaluation about the efficacy of acupuncture for the recovery of gastrointestinal function of patients with GC in the postoperative period, making up for the lack of relevant clinical evidence.INPLASY registration number:INPLASY2020110066.

Effects and Mechanisms of Transcutaneous Electrical Acustimulation on Postoperative Recovery After Elective Cesarean Section

To explore the effects and mechanisms of transcutaneous electrical acustimulation (TEA) on postoperative recovery after cesarean section (CS). A total of 108 women who underwent CS were randomized to receive TEA or sham-TEA. Four hours after CS, electrogastrogram (EGG) and electrocardiogram (ECG) were recorded for 30 min to assess gastric slow waves and autonomic functions, respectively. TEA at ST36 or sham-TEA at non-acupoints was performed for one hour right after recording ECG and EGG and then twice daily from postoperative days (POD) 1 to 3. In the morning of POD4, the EGG and ECG were recorded again for 30 min. TEA enhanced postoperative recovery associated with lower GI motility, reflected as a reduction in time of first flatus (p = 0.002) and time of first defecation (p < 0.001), an increase in the Bristol stool score (p < 0.001) and the number of SBMs (p < 0.001) in comparison with sham-TEA. TEA reduced symptoms associated with upper GI motility, including a reduction in time to resume semifluid (p = 0.008), and the total score of loss of appetite (p = 0.003) and belching (p = 0.038) from POD1 to POD3. Physiologically, TEA but not sham-TEA increased the percentage of normal gastric slow waves on POD4 compared with POD0 (p = 0.001). TEA reduced the visual analogue scale (VAS) pain score from POD1 to POD3 (p < 0.001). TEA but not sham-TEA increased vagal activity (p = 0.013) and decreased sympathetic activity (p = 0.013) on POD4 compared with POD0. Two factors were found to be independent predictors of shortened time of the first defecation: the use of TEA and a shorter surgical duration. Needleless non-invasive TEA at ST36 is effective in promoting both lower and upper GI symptoms after CS by enhancing vagal and suppressing sympathetic activities [Correction added on 23 June 2020, after first online publication: The first word of the preceded sentence has been corrected.].

Clinical efficacy and safety of somatostatin in the treatment of early postoperative inflammatory small bowel obstruction: A protocol for systematic review and meta analysis.

Background:As one of the complications after abdominal operation, early postoperative inflammatory small bowel obstruction (EPISBO) is a great trouble for many patients. The use of somatostatin in treating this disease had been widely reported, but its efficacy and safety were controversial. Therefore, the present research carried out a systematic review of the clinical efficacy and safety of somatostatin in treating EPISBO.Methods:Computer retrieval was conducted in foreign databases (including PubMed, The Cochrane Library, and Embase) and Chinese database (including Sino Med, CNKI, VIP, and WangFang Data), supplementary search for the literatures included was performed, and manual retrieval was performed in abstracts, books, and non-electronic magazines related to the present research to ensure the recall rate. Among all republished relevant experimental studies in Chinese and English from January 1, 1996 to February 1, 2020, randomized controlled trials on the curative efficacy of somatostatin for EPISBO were collected. The evaluation measures included patients’ total effective rate, peristaltic sound recovery time, time of disappearance of abdominal pain, time of first defecation after operation, drainage of gastrointestinal decompression and length of stay after treatment. The literatures were selected by two investigators independently to extract data according to the inclusion and exclusion criteria, Bias Risk Assessment Tool recommended by Cochrane Review Hand book 5.2 was used to assess literature quality, and meta-analysis was carried out by using soft Stata 12.0.Results:This study will scientifically and effectively analyze the clinical efficacy and safety of somatostatin in the treatment of EPISBO through systematic review and meta-analysis.Ethics and dissemination:The results of this study will be published in a peer-reviewed SCI journal to provide evidence-based medical evidence for the clinical treatment of early postoperative inflammatory bowel obstruction.Protocol and registration:Open Science Framework (https://osf.io, OSF), registration number: ryd2g.

Efficacy and Safety of Acupuncture at Tianshu (ST25) for Functional Constipation: Evidence from 10 Randomized Controlled Trials.

Objective To evaluate the evidence for the efficacy and safety of acupuncture at Tianshu (ST25) for functional constipation (FC). Methods We systematically searched seven databases to identify randomized controlled trials of acupuncture at ST25 alone or in combination with conventional therapy in the treatment of FC. Risk ratios (RRs) and mean differences (MDs) were calculated using RevMan 5.3 with 95% confidence interval (CI). Results The study included ten trials with 1568 participants. Meta-analysis showed that the Cleveland Constipation Score (CCS) for deep needling was significantly lower than that for lactulose (deep needling with low-frequency dilatational wave: MD −0.58, 95% CI −0.94 to −0.22; deep needling with sparse wave: MD −3.67, 95% CI −6.40 to −0.94; deep needling with high-frequency dilatational wave: MD −3.42, 95% CI −5.03 to −1.81). Furthermore, CCS for shallow needling with high-frequency dilatational wave was lower than that for lactulose (MD −1.77, 95% CI −3.40 to −0.14). In addition, when deep needling was combined with high-frequency dilatational wave, the weekly frequency of spontaneous defecation (FSD) was significantly higher than that for lactulose (MD 1.57, 95% CI 0.93 to 2.21). Colonic Transit Time (CTT) scores were significantly higher when deep needling was combined with sparse wave (MD −14.36, 95% CI −18.31 to −10.41) or high-frequency dilatational wave (MD −11.53, 95% CI −19.25 to −3.81). The time of first defecation after treatment (TFD) of the shallow needling therapy was significantly longer than that of the lactulose (MD 13.67, 95% CI 5.66 to 21.67). The CCS 6 months after treatment (CCS6m) for deep needling was significantly lower than that for lactulose (MD −4.90, 95% CI −5.97 to −3.84). Moreover, the FSD 6 months after treatment (FSD6m) for shallow needling was significantly higher than that for lactulose (MD 0.49, 95% CI 0.02 to 0.97). The adverse event (AE) rate for lactulose was significantly higher than that achieved with the needling treatments, and this held true for both deep needling therapy (RR 0.41, 95% CI 0.23 to 0.72) and shallow needling therapy (RR 0.33, 95% CI 0.15 to 0.77). Conclusions The meta-analysis demonstrates that acupuncture at ST25 appears to be more effective than lactulose in the treatment of functional constipation. This was found to be especially true for deep needling with high-frequency dilatational wave, which had a greater impact on improving CCS, FSD, CTT, and CCS6m. Additionally, acupuncture at ST25 was shown to be safer than conventional treatment, with the rate of AE being significantly lower for both deep needling and shallow needling. The trial is registered with https://www.crd.york.ac.uk/prospero/(CRD42019141017)).

Effects of chewing gum on gastrointestinal function in patients with intraspinal tumors after surgery

Objective To explore the effects of chewing gum on recovery of gastrointestinal function in patients with intraspinal tumors after surgery. Methods Totally 214 patients with intraspinal tumors treated in the Neurosurgical Ward of Spinal Cord and Spine of Beijing Tiantan Hospital, Capital Medical University from May 2018 to May 2019 were selected and divided into control (n=107) and observation (n=107) groups. Patients in the control group received conventional anti-constipation care, including postoperative dietary guidance, abdominal massage guidance and rehabilitation training, while patients in the observation group chewed 2 pieces of gum four times a day, each time for 10-15 min after awaking from anesthesia on the basis of conventional nursing care. Both groups received interventions for 7 d. The incidence of constipation and abdominal distension, time of first defecation and oral comfort scores after 7 d postoperatively. Results The incidence rate of constipation and abdominal distension was 7.48% and 15.89% in the observation group, lower than 25.23% and 37.38% in the control group, and there were statistically significant differences between the two groups (χ2=12.331, 12.650; P<0.05) . The time of first defecation was (19.22±5.64) h in the observation group, earlier than (27.08±6.61) in the control group, and there was statistically significant difference between the two groups (t=-9.366, P<0.05) . The oral comfort score after 7 d postoperatively was (8.59±1.13) in the observation group, higher than (5.12±2.66) in the control group, and there was statistically significant difference between the two groups (t=-12.420, P<0.05) . Conclusions Chewing gum can accelerate the recovery of gastrointestinal function in patients with intraspinal tumors after surgery and improve their oral comfort. Key words: Intraspinal neoplasms; Perioperative nursing; Fast track surgery; Gastrointestinal function; Gum

Clinical effect of oral olive oil combined with polyethylene glycol electrolyte on bowel preparation for chronic constipation patients

Objective To investigate the effectiveness and safety of oral olive oil combined with polyethylene glycol electrolyte (PEG) on bowel preparation before colonoscopy for chronic constipation patients. Methods A randomized, single-blind, prospective study was conducted on 180 patients with chronic constipation, who underwent colonoscopy at Tangdu Hospital of the Fourth Military Medical University from November 2017 to May 2018. Patients were randomly divided into three groups. Patients in group A took 60 mL olive oil and a piece of crystal sugar at 7: 30 pm the day before colonoscopy, followed by 1 500 mL PEG at 8: 00 pm before the test, and 1 500 mL PEG at 5: 00 am the day of colonoscopy. Patients in group B took 60 mL olive oil and a piece of crystal sugar after administration of PEG at 8: 00 pm the day before colonoscopy, followed by 1 500 mL PEG at 5: 00 am the day of colonoscopy. The group C was given 1 500 mL PEG at 8: 00 pm the day before colonoscopy, and another 1 500 mL PEG at 5: 00 am the day of colonoscopy. We recorded the time of first defecation after taking medication, the number of defecation before sleep, the total number of defecation, the score of Boston bowel preparation scale (BBPS) of the right, middle and left colon, and the adverse reactions, and compared the data among the three groups. The measurement data was compared using the analysis of variance. After the difference was found, the LSD-t test was used to compare between the two groups. The enumeration data was compared using the Pearson χ2 test. Results One patient in the group B terminated colonoscopy due to unable to continue cooperation during the examination. Group B and C both excluded one patient because of a large mass found in the descending colon of patients. Finally, there were 60 cases in the group A, 58 in the group B, and 59 in the group C. There was no statistical difference between the three groups in the general resource (P>0.05). The time of first defecation after taking medication for the group A, B and C was (2.25±2.32) h, (2.43±2.39) h and (3.36±2.79) h respectively, with statistical difference (F=3.36, P=0.037). The time of first defecation was longer in the group C than that of the group A and B (P=0.016 and P=0.046, respectively). The number of defecation before sleep for the group A, B and C was 3.47±2.09, 3.24±1.76 and 2.49±1.58 respectively, with statistical difference (F=4.65, P=0.011). The number of defecation before sleep was lesser in the group C than that of the group A and B (P=0.004, P=0.027, respectively). The total number of defecation for the group A, B and C was 7.20±2.67, 6.81±2.31 and 5.64±2.22 respectively. The difference among the three groups was statistically significant (F=6.68, P=0.002). For the group A and B, the total number of defecation was both more than that of the group C (P=0.001, P=0.010). There were no statistical differences among the three groups in the BBPS score of the left and middle colon and the total BBPS score (all P>0.05). The BBPS score of the right colon for the group A, B and C was 2.03±0.82, 1.95±0.87 and 1.53±0.80 respectively, with statistical difference (F=6.38, P=0.002), and was lower in the group C than that of the group A and B (P=0.001, P=0.006, respectively). Adverse reactions after taking medication including nausea, vomiting, abdominal pain, and bloating were respectively reported in 7, 3, 0 and 3 cases in the group A, 5, 3, 0 and 6 in the group B, and 4, 2, 1 and 4 in the group C, and there was no statistical difference among the three groups (χ2=4.35, P=0.824). Conclusion Administration of olive oil compared with PEG can improve the cleanness of right colon for chronic constipation patients, shorten the time of first defecation after taking medication, and increase the number of defecation before sleep and the total number of defecation during bowel preparation. Taking olive oil before or after PEG at the night before colonoscopy has no significantly effect on bowel preparation and adverse reactions. Key words: Colonoscopy; Olive oil; Polyethylene glycol electrolyte; Chronic constipation; Bowel preparation

Systematic review of the effect of early feeding after cesarean section on gastrointestinal function recovery

Objective To investigate the correlation between early postoperative diet and gastrointestinal function recovery after cesarean section. Methods A computerized search was performed through The Cochrane Library, PubMed, Embase, Web of Science, CBM, CNKI, Wanfang and VIP database for randomized controlled trails (RCTs) which studied the effects of early feeding after cesarean section on gastrointestinal function recovery. The analysis was performed after searching databases, assessing quality of included studies and extracting data using RevMan5.3. Results Totally 8 RCTs involving 1 474 patients were included. It showed that early eating could shorten the recovery time of bowel sounds, the time of passage of flatus, the time of first defecation (P 0.05). Conclusion Early eating after cesarean section can shorten the recovery time of gastrointestinal function, but it does not show advantages in improving the incidence of nausea and vomiting and abdominal distention. It is necessary to carry out in-depth study to verify. Key words: Cesarean section; Early feeding; Gastrointestinal function; Randomized controlled trial; Systematic review

Effects of individualized preoperative bowel preparation regimen on intestinal cleansing in patients with cervical cancer

Objective To investigate the effects of individualized preoperative bowel preparation regimen on intestinal cleansing in patients with cervical cancer. Methods Totally 140 patients who were admitted and diagnosed with cervical cancer in the Department of Oncology of Wuxi Maternal and Child Care Hospital from January 2016 to May 2017 were selected by convenient sampling and randomly divided into a control group and an experimental group by drawing method. Finally, totally 67 patients in each group completed the experiment. Routine preoperative bowel preparation was adopted for patients in the control group, while individualized bowel preparation regimen was adopted for patients in the experimental group, including evaluation before medication, activity guidance for patients with different ages, control of medication speed and response to untoward effects. The intestinal cleansing, untoward effects, time of first defecation and total time of defecation were compared between the patients in the two groups. The rank-sum test, χ2 test and t test were used to analyze the data for the patients in the two groups. Results There was statistically significant difference in the degree of intestinal cleansing between the patients in the two groups (Z=-2.732, P<0.05) ; there was statistically significant difference in the degree of nausea and vomiting between the patients in the two groups (Z=-2.065, P<0.05) ; there was statistically significant difference in the degree of abdominal distension between the patients in the two groups (Z=-2.526, P<0.05) ; and there was statistically significant difference in the incidence of stomachache between the patients in the two groups (χ2=5.835, P<0.05) . The time of first defecation and the total time of defecation of the patients in the experimental group was shorter than that of the patients in the control group (t=-3.901, -6.689; P<0.01) . Conclusions The individualized preoperative bowel preparation for patients with cervical cancer can improve the intestinal cleansing, shorten the time of defecation and reduce untoward effects such as abdominal distension and stomachache in these patients. Key words: Cervical neoplasms; Polyethylene glycol electrolytes powder; Intestinal cleansing