107 Systematic review of definitions and outcome measures for postoperative ileus and return of bowel function after abdominal surgery in children Chapter 4 Primary outcome The primary outcomes include the definitions and outcome measures for postoperative ileus or return of bowel function in children. Definitions Only outcomes directly describing postoperative ileus or return of bowel function were considered. Studies with outcomes describing hospital discharge (e.g. patients were discharged when full enteral feeding was tolerated) and studies that only reported generic measures of recovery (e.g. time to discharge) were excluded. The obtained outcomes were categorized as “gastric motility” when the outcome described the ability to tolerate food in and through the stomach (e.g. time to full diet) or a lack thereof (e.g. vomiting) and as “intestinal motility” when the outcome was related to the functioning of the lower gastrointestinal tract by means of stool passage (e.g. time to pass first flatus or abdominal distension). Two outcomes, namely time to parenteral nutrition and abdominal distension, were assessed as being related to the functioning of both gastric- and intestinal motility and were therefore categorized as “both”. Age group which was defined following Medline Mesh terms (new-born: 0-1 month, infant: 1 month - 2 years, preschool: 2-5 years, child: 6-12 years, adolescent: 13-18 years). Articles were grouped based on the reported mean age of study population. Data extraction Titles and abstracts were screened by two independent researchers (LES, IS) using the Rayyan software. Rayyan is an online based software that facilitates blind collaboration among reviewers (11). The discrepancies that originated were discussed till consensus was reached. A third specialist author was consulted if consensus was not reached. Afterwards, the full text of the remaining articles was read to determine eligibility for inclusion. During the screening process the references of encountered systematic reviews and meta-analyses were screened to identify additional studies. Statistical analysis The data was displayed using basic descriptive statistics including frequencies, proportions and ranges. Bias assessment Since this review does not report a measure of clinical data but rather a summary description of definitions and outcome measures used in RCTs, risk of bias was not assessed.
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