The Effectiveness Of Somatostatin In Treating Early Postoperative Inflammatory Small Bowel Obstruction: A Meta-analysis

Aims: To explore the effectiveness of somatostatin in inflammatory bowel obstruction after abdominal surgery by perfoming a meta-analysis.Methods: Based on the databases getting from medical literatures relating to somatostatin in treatment of inflammatory bowel obstruction, which conducted by randomized controlled trials(RCT) from 1995 to 2014.And they were collected by two investigators independently from databases including the CNKI, Wanfang database, Chinese Biomedical Literature Database(CBM) and Pub Med, EMBase, Cochrane Library. Data on study methods and results were also independently extracted by two investigators after elimination of the incompetent literatures and quality assessment according to Jadad rating scale. Statistical analysis was performed using the Rev Man 5.3 software.Evaluation index was the influence of somatostatin for inflammatory bowel obstruction after abdominal surgery, including transit operation rate, abdominal windy disappear time, pass first flatus time, length of hospital stay, peristaltic sounds recovery time, the amount of gastrointestinal decompression and the disappearing time of abdominal pain.Results: Eleven eligible RCTs enrolling 737 patients were included in the meta-analysis, The patients data of the somatostatin group compared with the conventional treatment group shows:(1)results of overall consolidation effect of transit operation rate in the somatostatin group was lower than the conventional treatment group(OR=0.12,95%CI=[0.05,0.32],P <0.05);(2)the disappearing time of abdominal windy in the somatostatin group was earlier than the conventional treatment group(MD =-2.51,95%CI=[-2.89,-2.13], P <0.05);(3)the time to pass first flatus in the somatostatin group was earlier than the conventional treatment group(SMD=-1.17,95%CI = [-1.37,-0.97], P <0.05);(4)the length of hospital stay in the somatostatin group was lower than the conventional treatment group(MD=-4.85,95%CI = [-5.33,-4.36], P <0.05);(5)the recovery time of peristaltic sounds in the somatostatin group was earlier than the conventional treatment group(MD=-1.30, 95%CI= [-1.84,-0.75], P<0.05);(6)the amount of gastrointestinal decompression in the somatostatin group was lower than the conventional treatment group(SMD=-2.33,95%CI=[-2.58,-2.07],P<0.05);(7)the disappearing time of abdominal pain in the somatostatin group was earlier than the conventional treatment group(MD=-1.87,95%CI=[-2.40,-1.35],P<0.05).Conclusion: Compared with the conventional treatment, somatostatin can be used as an effective treatment drug for patients with inflammatory bowel obstruction after abdominal surgery for not only avoiding reoperation in a larger extent, but also reducing abdominal windy disappear time, pass first flatus time, length of hospital stay, peristaltic sounds recovery time and the amount of gastrointestinal decompression.