Length of hospital stay
On the basis of the literature, 30 studies reporting post-operative
length of hospital stay were included although 25 give useable data for
statistical
analysis12,13,15,16,18–23,25,27–29,31,36,38–43,45,46,48.
A total of 25 studies with 3,958 patients and 8 pharmacological
treatments are reported. The extracted data are detailed in Supplemental
Table 8.1. The following treatments were studied and included in the
network analysis: NSAIDs, gastrografin, colloid infusion, oral
carbohydrates, prokinetics, probiotics, erythromycin and opioid
antagonists. Figure 6 reports the network map for the 8 pharmacological
treatment classes analysed. The main results are reported in Figure 6:
network map, relative effect Bayesian plot, rankogram and the surface
under the cumulative ranking curve (SUCRA).
Of the 8 treatments studied, prokinetics (Mean difference (MD) (hours)
– 1.9; credible interval – 3.8, - 0.040 (Figure 6.B); SUCRA 0.34
(Figure 6.C)) showed a significantly faster onset of first stools
compared to the control treatments. Gastrografin was the best treatment
for the duration of flatus recovery with a probability of P=0.41. The
ranking (rank1+rank2+rank3) in descending order of the top three
treatments from the best to the third was as follows: gastrografin had a
73% (0.41+0.20+0.11) probability of being among the top three therapies
followed by colloid infusion at 50% (0.21+0.17+0.11) and then
prokinetics with 47% (0.05+0.17+0.25). The bias studies are summarised
in Supplemental Figure 8.6. The overall bias was rated low risk in 92%
of studies and of some concern in 8% of studies. The highest ratio of
some concern was for deviations from intended interventions (24%).