Kovoor, J.G.Stretton, B.Jacobsen, J.H.W.Gupta, A.K.Ovenden, C.D.Hewitt, J.N.Glynatsis, J.M.Edwards, S.Campbell, K.Asokan, G.P.Tivey, D.R.Babidge, W.J.Rayner, C.K.Anthony, A.A.Trochsler, M.I.Horowitz, M.Hewett, P.J.Jones, K.L.Maddern, G.J.2025-07-132025-07-132021BMJ Open, 2021; 11(10):e054704-1-e054704-42044-60552044-6055https://hdl.handle.net/2440/145890Introduction: Gastrointestinal recovery after surgery is of worldwide significance. Postoperative gastrointestinal dysfunction is multifaceted and known to represent a major source of postoperative morbidity, however, its significance to postoperative care across all surgical procedures is unknown. The complexity of postoperative gastrointestinal recovery is poorly defined within gastrointestinal surgery, and even less so outside this field. To inform the clinical care of surgical patients worldwide, this systematic review and meta-analysis will aim to characterise the duration of postoperative gastrointestinal recovery that can be expected across all surgical procedures and determine the associations between factors that may affect this. Methods and analysis: MEDLINE, Embase, Cochrane Library and CINAHL will be searched for studies reporting the time to first postoperative passage of stool after any surgical procedure. We will screen records, extract data and assess risk of bias in duplicate. Forest plots will be constructed for time to postoperative gastrointestinal recovery, as assessed by various outcome measures. Because of potential heterogeneity, a random-effects model will be used throughout the meta-analysis. Funnel plots will be used to test for publication bias. Meta-regressions will be undertaken where the outcome is the mean time to first postoperative passage of stool, with potential predictors and confounders being patient characteristics, postoperative outcomes and surgical factors. Ethics and dissemination: This study will not involve human or animal subjects and, thus, does not require ethics approval. The outcomes will be disseminated via publication in peer-reviewed scientific journal(s) and presentations at scientific conferences. PROSPERO registration number: CRD42021256210.en© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. Open access This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.Gastrointestinal recovery; Gastrointestinal; Postoperative gastrointestinal dysfunction; gastrointestinal surgery; surgical proceduresHumansResearch DesignPublication BiasMeta-Analysis as TopicSystematic Reviews as TopicJournal article10.1136/bmjopen-2021-0547042024-05-06591428Kovoor, J.G. [0000-0002-3880-3840]Stretton, B. [0000-0002-7939-3489]Gupta, A.K. [0000-0002-8038-0378]Ovenden, C.D. [0000-0001-8075-7852]Hewitt, J.N. [0000-0003-2959-4554]Edwards, S. [0000-0003-2074-1685]Tivey, D.R. [0000-0003-2213-2576]Babidge, W.J. [0000-0002-7063-7192]Rayner, C.K. [0000-0002-5527-256X]Trochsler, M.I. [0000-0001-6961-1430] [0000-0002-0650-9153]Horowitz, M. [0000-0002-0942-0306]Jones, K.L. [0000-0002-1155-5816]Maddern, G.J. [0000-0003-2064-181X]