Randomized clinical study of Gastrografin® administration in patients with adhesive small bowel obstruction

Biondo, Sebastián; Parés, David; Mora, Laura; Ragué, J Martí; Kreisler, Esther; Jaurrieta, E

doi:10.1002/bjs.4150

Cited by 135 publications

(124 citation statements)

References 14 publications

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“…Another study 14 included patients who did not have previous abdominal surgery; only those with adhesive small bowel obstruction were included in the present analysis. The study of Biondo and colleagues 18 was analysed in both the diagnostic and the therapeutic arms of the review, hence there are six studies in each arm. Exclusion criteria were similar for all studies and included patients who had surgery within the 6 weeks before the episode of small bowel obstruction, those with signs of strangulation or peritonitis, carcinomatosis or irreducible hernia, and patients who showed signs of resolution of obstruction at the time of admission.…”

Section: Characteristics Of Selected Studiesmentioning

confidence: 99%

“…Studies that examined the therapeutic role of Gastrografin  randomized patients to 100 ml Gastrografin  or placebo, orally or via a nasogastric tube, which was then clamped for 60 min. Patients were otherwise treated similarly 5,11,15,18,22,23 .…”

Section: Characteristics Of Selected Studiesmentioning

confidence: 99%

“…It was double blinded, and concealment method and dropouts were described. The other five studies were described as prospective randomized trials 5,11,15,18,23 . Each of these scored 2 on the Jadad scale 1 .…”

Section: Quality Of Included Studiesmentioning

confidence: 99%

“…Although this was independent of the initial radiology, further radiography was performed to assess ongoing obstruction except in one study 22 . The radiography results may have influenced the decision to operate in the study of Biondo and colleagues 18 as patients who needed surgery in the Gastrografin  group underwent operation significantly earlier. Time allowed for non-operative resolution varied from 48 h 11 to 5 days 15 .…”

Section: Quality Of Included Studiesmentioning

confidence: 99%

“…All six studies addressed this question 5,11,15,18,22,23 . There was no significant difference between Gastrografin  and placebo in the rate of resolution of small bowel obstruction without surgery (OR 0·81 (95 per cent c.i.…”

Section: Resolution Of Obstruction or Surgerymentioning

confidence: 99%

See 4 more Smart Citations

Meta-analysis of oral water-soluble contrast agent in the management of adhesive small bowel obstruction

Abbas

Bissett

Parry

2007

British Journal of Surgery

101

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Background: Adhesions are the leading cause of small bowel obstruction. Identification of patients who require surgery is difficult. This review analyses the role of Gastrografin  as a diagnostic and therapeutic agent in the management of adhesive small bowel obstruction.Methods: A systematic search of Medline, Embase and Cochrane databases was performed to identify studies of the use of Gastrografin  in adhesive small bowel obstruction. Studies that addressed the diagnostic role of water-soluble contrast agent were appraised, and data presented as sensitivity, specificity, and positive and negative likelihood ratios. Results were pooled and a summary receiver-operator characteristic (ROC) curve was constructed. A meta-analysis of the data from six therapeutic studies was performed using the Mantel-Haenszel test and both fixed-and random-effect models.Results: The appearance of water-soluble contrast agent in the colon on an abdominal radiograph within 24 h of its administration predicted resolution of obstruction with a pooled sensitivity of 97 per cent and specificity of 96 per cent. The area under the summary ROC curve was 0·98. Water-soluble contrast agent did not reduce the need for surgical intervention (odds ratio 0·81, P = 0·300), but it did reduce the length of hospital stay for patients who did not require surgery compared with placebo (weighted mean difference −1·84 days; P < 0·001). Conclusion:Published data strongly support the use of water-soluble contrast medium as a predictive test for non-operative resolution of adhesive small bowel obstruction. Although Gastrografin  does not reduce the need for operation, it appears to shorten the hospital stay for those who do not require surgery.

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Section: Characteristics Of Selected Studiesmentioning

confidence: 99%