106 Chapter 4 were the most frequently used outcome measures (6). Whilst our experience suggests that in children the return of gastric motility, being able to tolerate feeding, is more important. Intake is more important in young children since the higher metabolic rate makes them more vulnerable for dehydration and hypoglycaemia compared to adults (8, 9). If these nuances do exists, it could lead to either misuse or disuse of the upcoming core outcome set and definitions in adults. Therefore this review aims to report on the variation in reported definitions and outcome measures used for both return of bowel function and postoperative ileus in prospective studies of gastrointestinal procedures performed in children (defined as up to 18 years of age). Methods Study design A systematic review was performed in accordance with the PRISMA guidelines (10). The protocol was prospectively registered with the International Prospective Register of Systematic Reviews (PROSPERO) on the 28th of January 2021 (registration number: CRD42021233781). Search strategy To identify all relevant publications we conducted systematic searches in the bibliographic databases PubMed and Embase.com from inception to December 17, 2020, in collaboration with a medical information specialist. The following terms were used (including synonyms and closely related words) as index terms or free-text words: "Ileus", "Intestinal surgery", "Children (0-18)", "Prospective studies". Duplicate articles were excluded. All languages were accepted. The full search strategies for all databases can be found in Appendix 1. Eligible studies All studies with a prospective design were included reporting on definitions and/ or outcome measures for post-operative ileus or return of bowel function following gastrointestinal surgery in children (up to 18 years) were considered for inclusion. Animal studies, in vitro studies, non-English, conference abstracts, protocols and studies with less than ten cases were excluded.
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