Time to passage of first stools
According to the literature, 19 studies reporting post-operative time to
first stools were included although 13 give useable data for statistical
analysis15–17,20,21,36,37,40,44–48. A total of 13
studies with 1,125 patients and 6 pharmacological treatments are
reported. The extracted data are detailed in Supplemental Table 5.1. The
following treatments were studied and included in the network analysis:
gastrografin, dexamethasone, colloid infusion, oral carbohydrates,
prokinetics and probiotics. Figure 3.A reports the network map for the 6
pharmacological treatment classes analysed. The main results are
reported in Figure 3: network map, relative effect Bayesian plot,
rankogram and the surface under the cumulative ranking curve (SUCRA).
Of the 6 treatments studied, prokinetics (Mean difference (MD) (hours) -
23; credible interval - 43, - 4.3 (Figure 3.B); SUCRA 0.424 (Figure
3.C)) and dexamethasone (Mean difference (MD) (hours) - 47; credible
interval - 88, - 6.0 (Figure 3.B); SUCRA 0.113 (Figure 3.C)) showed a
significantly faster onset of first stools compared to the control
treatments. Dexamethasone was the best treatment for the duration of
flatus recovery with a probability of P=0.67. The ranking
(rank1+rank2+rank3) in descending order of the top three treatments from
the best to the third was as follows: dexamethasone had a 90%
(0.67+0.16+0.07) probability of being among the top three therapies
followed by prokinetics at 50% (0.28+0.18+0.03) and then probiotics
with 41% (0.05+0.17+0.18). The bias studies are summarised in
Supplemental Figure 5.6. The overall bias was rated low risk in 92.3%
of studies and of some concern in 7.7% of studies. The highest ratio of
some concern was due to the randomisation process and deviations from
intended interventions (23.1%) as well as deviation from intended
intention (23.1%).