67 The incidence of different forms of ileus following surgery for abdominal birth defects in infants Chapter 3 Risk of bias was assessed and is shown in Table 2. Most studies included reported fair quality on the NOS which was also the case for the two RCTs using the Jadad score. The mean scores on the NOS of articles describing paralytic ileus and early anastomotic stenosis was slightly lower (5,5) compared to articles describing adhesive small bowel obstruction and late onset anastomotic stenosis (6). Paralytic Ileus In total, 22 studies reported on paralytic ileus and entailed 1332 patients and 120 events of paralytic ileus [64, 66, 85, 90, 108, 122, 177, 228-230, 232, 251, 261, 262, 265, 268, 271, 273, 274, 285, 300, 303]. The pooled proportion of total paralytic ileus was 0.07 (95%-CI: 0.05 – 0.11; I2 = 71%, p ≤ 0.01). Separate pooled proportions were calculated for the following conditions: Hirschsprung’s disease 0.07 (95%-CI: 0.02-0.24; n=45/426; I2 = 91%; p ≤ 0.01); small intestinal atresia 0.05 (95%-CI: 0.03-0.09; n=16/314; I2 = 18%; p = 0.25); gastroschisis 0.14 (95%-CI: 0.080.23; n=30/228; I2 = 52%; p = 0.03); biliary atresia 0.05 (95%-CI: 0.02-0.11; n=5/103; I2 = 0%; p = 0.45); omphalocele 0.05 (95%-CI: 0.02-0.13; n=5/96; I2 = 8%; =0.27); anorectal malformations 0.06 (95%-CI: 0.03-0.15; n=5/77; I2 = 0%; p = 0.83). Duodenal obstruction (N=58) and congenital diaphragmatic hernia (N=30) are included in the overall proportion but did not meet the criteria for separate statistical analysis (Figure 2). Figure 2 - Pooled proportion of paralytic ileus
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