{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T10:15:30Z","timestamp":1774260930739,"version":"3.50.1"},"reference-count":42,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2021,2,15]],"date-time":"2021-02-15T00:00:00Z","timestamp":1613347200000},"content-version":"vor","delay-in-days":264,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,5,27]],"date-time":"2020-05-27T00:00:00Z","timestamp":1590537600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,5,27]],"date-time":"2020-05-27T00:00:00Z","timestamp":1590537600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100004374","name":"Medtronic Colorectal Research Fellowship Supplementary Scholarship","doi-asserted-by":"publisher","award":["a1753714"],"award-info":[{"award-number":["a1753714"]}],"id":[{"id":"10.13039\/100004374","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100011371","name":"Royal Australasian College of Surgeons W.G. Norman Research Scholarship","doi-asserted-by":"publisher","award":["(RACS ID 187648)"],"award-info":[{"award-number":["(RACS ID 187648)"]}],"id":[{"id":"10.13039\/100011371","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004374","name":"Medtronic","doi-asserted-by":"publisher","award":["a1753714"],"award-info":[{"award-number":["a1753714"]}],"id":[{"id":"10.13039\/100004374","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100011371","name":"Royal Australasian College of Surgeons","doi-asserted-by":"publisher","award":["(RACS ID 187648)"],"award-info":[{"award-number":["(RACS ID 187648)"]}],"id":[{"id":"10.13039\/100011371","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,8,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Recovery of gastrointestinal function is often delayed after major abdominal surgery, leading to postoperative ileus (POI). Enhanced recovery protocols recommend laxatives to reduce the duration of POI, but evidence is unclear. This systematic review aimed to assess the safety and efficacy of laxative use after major abdominal surgery.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Ovid MEDLINE, Embase, Cochrane Library and PubMed databases were searched from inception to May 2019 to identify eligible RCTs focused on elective open or minimally invasive major abdominal surgery. The primary outcome was time taken to passage of stool. Secondary outcomes were time taken to tolerance of diet, time taken to flatus, length of hospital stay, postoperative complications and readmission to hospital.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Five RCTs with a total of 416 patients were included. Laxatives reduced the time to passage of stool (mean difference (MD) \u22120\u00b783 (95 per cent c.i. \u22121\u00b739 to \u22120\u00b726) days; P = 0\u00b7004), but there was significant heterogeneity between studies for this outcome measure. There was no difference in time to passage of flatus (MD \u22120\u00b717 (\u22120\u00b759 to 0\u00b725) days; P = 0\u00b7432), time to tolerance of diet (MD \u22120\u00b701 (\u22120\u00b712 to 0\u00b710) days; P = 0\u00b7865) or length of hospital stay (MD 0\u00b701(\u22121\u00b736 to 1\u00b738) days; P = 0\u00b7992). There were insufficient data available on postoperative complications for meta-analysis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Routine postoperative laxative use after major abdominal surgery may result in earlier passage of stool but does not influence other postoperative recovery parameters. Better data are required for postoperative complications and validated outcome measures.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1002\/bjs5.50301","type":"journal-article","created":{"date-parts":[[2020,5,27]],"date-time":"2020-05-27T10:39:42Z","timestamp":1590575982000},"page":"577-586","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Safety and efficacy of laxatives after major abdominal surgery: systematic review and meta-analysis"],"prefix":"10.1093","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9775-3599","authenticated-orcid":false,"given":"N N","family":"Dudi-Venkata","sequence":"first","affiliation":[{"name":"Colorectal Unit, Department of Surgery, Royal Adelaide Hospital , Adelaide, South Australia, Australia"},{"name":"Discipline of Surgery, Faculty of Health and Medical Sciences, School of Medicine, University of Adelaide , Adelaide, South Australia, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5024-1000","authenticated-orcid":false,"given":"W","family":"Seow","sequence":"additional","affiliation":[{"name":"Discipline of Surgery, Faculty of Health and Medical Sciences, School of Medicine, University of Adelaide , Adelaide, South Australia, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H M","family":"Kroon","sequence":"additional","affiliation":[{"name":"Colorectal Unit, Department of Surgery, Royal Adelaide Hospital , Adelaide, South Australia, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S","family":"Bedrikovetski","sequence":"additional","affiliation":[{"name":"Discipline of Surgery, Faculty of Health and Medical Sciences, School of Medicine, University of Adelaide , Adelaide, South Australia, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J W","family":"Moore","sequence":"additional","affiliation":[{"name":"Colorectal Unit, Department of Surgery, Royal Adelaide Hospital , Adelaide, South Australia, Australia"},{"name":"Discipline of Surgery, Faculty of Health and Medical Sciences, School of Medicine, University of Adelaide , Adelaide, South Australia, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M L","family":"Thomas","sequence":"additional","affiliation":[{"name":"Colorectal Unit, Department of Surgery, Royal Adelaide Hospital , Adelaide, South Australia, Australia"},{"name":"Discipline of Surgery, Faculty of Health and Medical Sciences, School of Medicine, University of Adelaide , Adelaide, South Australia, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T","family":"Sammour","sequence":"additional","affiliation":[{"name":"Colorectal Unit, Department of Surgery, Royal Adelaide Hospital , Adelaide, South Australia, Australia"},{"name":"Discipline of Surgery, Faculty of Health and Medical Sciences, School of Medicine, University of Adelaide , Adelaide, South Australia, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,5,27]]},"reference":[{"key":"2023020206424287900_bjs550301-bib-0001","doi-asserted-by":"crossref","first-page":"962","DOI":"10.1007\/s11605-013-2148-y","article-title":"Defining postoperative ileus: results of a systematic review and global survey","volume":"17","author":"Vather","year":"2013","journal-title":"J Gastrointest Surg"},{"key":"2023020206424287900_bjs550301-bib-0002","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1111\/ans.12102","article-title":"Management of prolonged post-operative ileus: evidence-based recommendations","volume":"83","author":"Vather","year":"2013","journal-title":"ANZ J Surg"},{"key":"2023020206424287900_bjs550301-bib-0003","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1016\/j.surg.2016.05.026","article-title":"Intraperitoneally administered, hydrogen-rich physiologic solution protects against postoperative ileus and is associated with reduced nitric oxide production","volume":"160","author":"Okamoto","year":"2016","journal-title":"Surgery"},{"key":"2023020206424287900_bjs550301-bib-0004","doi-asserted-by":"crossref","DOI":"10.1001\/jamasurg.2016.4681","article-title":"Associations of specific postoperative complications with outcomes after elective colon resection: a procedure-targeted approach toward surgical quality improvement","volume":"152","author":"Scarborough","year":"2017","journal-title":"JAMA Surg"},{"key":"2023020206424287900_bjs550301-bib-0005","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1097\/01.sla.0000179621.33268.83","article-title":"Participants in the VA National Surgical Quality Improvement Program. 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