104 Chapter 4 Abstract Background: This review aims to objectify which definitions and outcome measures are used for return of bowel function and postoperative ileus in children. Method: PubMed and Embase were systematically searched from inception to December 17,2020. Prospective studies conducted in children (aged 0-18 years) undergoing gastrointestinal surgery which reported on definitions and/or outcome measures for post-operative ileus or return of bowel function were evaluated. Definitions and outcome measures were extracted. Results: From 4027 references, 71 articles were included. From the 17 articles mentioning postoperative ileus, 8 (47%) provided a definition. In total 34 outcome measures were used, 12 were unique. “Abdominal distension” was the most reported (41%) measure. In 41%, the outcome measures only described the return of gastric motility whilst 18% described the return of intestinal motility. Return of bowel function was mentioned in 67 articles, none provided a definition. In total 133 outcome measures were used, 37 were unique. Time to oral intake was the most reported (14%) measure. In 49%, the outcome measures only described return of gastric motility whilst 10% described return of intestinal motility. Conclusions: High variation in definitions and outcome measures have limited the generalizability of research into postoperative bowel function in children. Without standardization it will be impossible to compare research results and evaluate treatments. In children return of gastric motility seemingly should get more focus compared to adults. Therefore, we believe that a definition for postoperative ileus with an accompanying core outcome set, developed by a multidisciplinary team, specifically for children is required.
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