Document Detail


Systematic review and meta-analysis of the diagnostic and therapeutic role of water-soluble contrast agent in adhesive small bowel obstruction.
MedLine Citation:
PMID:  20205228     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: This meta-analysis assessed the diagnostic and therapeutic role of water-soluble contrast agent (WSCA) in adhesive small bowel obstruction (SBO). METHODS: PubMed, Embase and Cochrane databases were searched systematically. The primary outcome in the diagnostic role of WSCA was its ability to predict the need for surgery. In the therapeutic role, the following were evaluated: resolution of SBO without surgery, time from admission to resolution, duration of hospital stay, complications and mortality. To assess the diagnostic role of WSCA, pooled estimates of sensitivity, specificity, positive and negative predictive values, and likelihood ratios were derived. For the therapeutic role of WSCA, weighted odds ratio (OR) and weighted mean difference (WMD) were obtained. RESULTS: Fourteen prospective studies were included. The appearance of contrast in the colon within 4-24 h after administration had a sensitivity of 96 per cent and specificity of 98 per cent in predicting resolution of SBO. WSCA administration was effective in reducing the need for surgery (OR 0.62; P = 0.007) and shortening hospital stay (WMD -1.87 days; P < 0.001) compared with conventional treatment. CONCLUSION: Water-soluble contrast was effective in predicting the need for surgery in patients with adhesive SBO. In addition, it reduced the need for operation and shortened hospital stay.
Authors:
B C Branco; G Barmparas; B Schnüriger; K Inaba; L S Chan; D Demetriades
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Publication Detail:
Type:  Journal Article; Meta-Analysis; Review    
Journal Detail:
Title:  The British journal of surgery     Volume:  97     ISSN:  1365-2168     ISO Abbreviation:  Br J Surg     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-03-10     Completed Date:  2010-03-31     Revised Date:  2010-07-14    
Medline Journal Info:
Nlm Unique ID:  0372553     Medline TA:  Br J Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  470-8     Citation Subset:  AIM; IM    
Copyright Information:
Copyright (c) 2010 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Affiliation:
Division of Trauma, Emergency Surgery and Surgical Critical Care, University of Southern California, Los Angeles, California, USA.
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MeSH Terms
Descriptor/Qualifier:
Contrast Media / diagnostic use*
Diatrizoate Meglumine / diagnostic use*
Humans
Intestinal Obstruction / mortality,  radiography*
Intestine, Small
Iohexol / diagnostic use*
Length of Stay
Randomized Controlled Trials as Topic
Tissue Adhesions / mortality,  radiography
Chemical
Reg. No./Substance:
0/Contrast Media; 131-49-7/Diatrizoate Meglumine; 66108-95-0/Iohexol
Comments/Corrections
Comment In:
Br J Surg. 2010 Aug;97(8):1311; author reply 1311-2   [PMID:  20603843 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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