Use of acetylcholinesterase inhibitors in reducing time to gastrointestinal function recovery following abdominal surgery: A systematic review

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dc.contributor.authorTraeger, L.
dc.contributor.authorDudi-Venkata, N.
dc.contributor.authorBedrikovetski, S.
dc.contributor.authorKroon, H.M.
dc.contributor.authorMoore, J.W.
dc.contributor.authorSammour, T.
dc.date.issued2024
dc.description.abstractIntroduction: Postoperative ileus (POI) is a significant complication following abdominal surgery, increasing morbidity and mortality. The cholinergic anti-inflammatory response is one of the major pathways involved in developing POI, but current recommendations to prevent POI do not target this. This review aims to summarise evidence for the use of acetylcholinesterase inhibitors, neostigmine and pyridostigmine, to reduce the time to return of gastrointestinal function (GI) following abdominal surgery. Methods: A systematic search of various databases was performed from 1946 to May 2023. Randomised controlled trials (RCTs) on acetylcholinesterase inhibitors in intra-abdominal surgery were included. Data on time to flatus and/or stool and side effects were extracted. Results: Among 776 screened manuscripts, 8 RCTs (703 patients) investigating acetylcholinesterase inhibitors in intra-abdominal surgery were analysed. Five studies showed a significant reduction in time to flatus and/or stool by 17–47.6 h. Methodological variations, differing procedure types, and potential bias were observed. Limited studies reported side effects or length of stay. Conclusion: Acetylcholinesterase inhibitors may reduce the time for GI to return. However, current evidence is limited and biased. Further studies incorporating acetylcholinesterase inhibitors in an enhanced recovery protocol are required to address this question, especially for patients undergoing colorectal surgery.
dc.description.statementofresponsibilityLuke Traegera, Nagendra Dudi-Venkataa, Sergei Bedrikovetski, Hidde M. Kroon, b James W. Moore, Tarik Sammour
dc.identifier.citationDigestive Surgery, 2024; 41(1):12-23
dc.identifier.doi10.1159/000535753
dc.identifier.issn0253-4886
dc.identifier.issn1421-9883
dc.identifier.orcidTraeger, L. [0000-0002-0327-7334]
dc.identifier.orcidBedrikovetski, S. [0000-0001-9330-625X]
dc.identifier.orcidKroon, H.M. [0000-0002-8923-7527]
dc.identifier.orcidSammour, T. [0000-0002-4918-8871]
dc.identifier.urihttps://hdl.handle.net/2440/141855
dc.language.isoen
dc.publisherS. Karger AG
dc.rights© 2023 The Author(s). Published by S. Karger AG, Basel. This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License .
dc.source.urihttp://dx.doi.org/10.1159/000535753
dc.subjectSurgery; Postoperative ileus; Acetylcholinesterase inhibitors; Colorectal surgery
dc.titleUse of acetylcholinesterase inhibitors in reducing time to gastrointestinal function recovery following abdominal surgery: A systematic review
dc.typeJournal article
pubs.publication-statusPublished

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