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The effect of simethicone on postoperative ileus in patients undergoing colorectal surgery (SPOT), a randomized controlled trial.
- Source :
-
International journal of surgery (London, England) [Int J Surg] 2018 Aug; Vol. 56, pp. 141-147. Date of Electronic Publication: 2018 Jun 12. - Publication Year :
- 2018
-
Abstract
- Background: Postoperative ileus is a poorly understood multifactorial outcome following colorectal surgery that presents significant clinical challenges and contributes to increased morbidity, length of stay, and healthcare cost. To date, there are few pharmacological interventions that shorten the duration of postoperative ileus.<br />Objective: This study is the first to evaluate the efficacy of simethicone in treating postoperative ileus symptoms in patients undergoing colorectal surgery.<br />Design: A multicenter, double-blinded, placebo controlled randomized controlled trial.<br />Settings: This trial was conducted at two academic tertiary care centres in Ontario, Canada.<br />Participants: 118 patients undergoing colorectal surgery.<br />Interventions: Patients were randomized to receive either a five-day course of oral simethicone (n = 58) or a placebo (n = 60).<br />Main Outcome Measures: The primary outcome was time to first passage of flatus. Secondary outcomes included time to first bowel movement, postoperative length of stay, and postoperative pain. Statistical analyses were performed on an intention-to-treat basis. Statistical significance set at p = 0.05.<br />Results: The median time to first passage of flatus in simethicone arm was 25.2 h and 26.7 h in controls (P = 0.98). There were no significant differences in the median time to first bowel movement (simethicone = 41.1 h vs. control = 42.9 h, P = 0.91) or median length of hospital stay (simethicone = 4.5 days vs. control = 4.0 days, P = 0.63).<br />Conclusions: This study failed to show a difference in return of gastrointestinal motility in patients receiving simethicone following colorectal surgery. Postoperative ileus remains a significant clinical and economic burden to the healthcare system and further research is needed to identify a reliable and effective method of treatment.<br /> (Copyright © 2018 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.)
- Subjects :
- Aged
Canada
Colon surgery
Defecation drug effects
Double-Blind Method
Female
Gastrointestinal Motility drug effects
Humans
Ileus etiology
Length of Stay
Male
Middle Aged
Pain, Postoperative etiology
Postoperative Complications etiology
Postoperative Period
Rectum surgery
Treatment Outcome
Antifoaming Agents therapeutic use
Digestive System Surgical Procedures adverse effects
Ileus drug therapy
Postoperative Complications drug therapy
Simethicone therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 1743-9159
- Volume :
- 56
- Database :
- MEDLINE
- Journal :
- International journal of surgery (London, England)
- Publication Type :
- Academic Journal
- Accession number :
- 29906642
- Full Text :
- https://doi.org/10.1016/j.ijsu.2018.06.011