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Cochrane Database of Systematic Reviews

Contraste hidrosoluble oral para la obstrucción intestinal maligna

Información

DOI:
https://doi.org/10.1002/14651858.CD012014.pub2Copiar DOI
Base de datos:
  1. Cochrane Database of Systematic Reviews
Versión publicada:
  1. 07 marzo 2018see what's new
Tipo:
  1. Intervention
Etapa:
  1. Review
Grupo Editorial Cochrane:

  1. Grupo Cochrane de Dolor y cuidados paliativos

Copyright:
  1. Copyright © 2018 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

Cifras del artículo

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Contraer

Autores

  • William Syrmis

    Correspondencia a: St Vincent’s Private Hospital, Brisbane, Australia

    [email protected]

  • Russell Richard

    St Vincent’s Private Hospital, Brisbane, Australia

  • Sue Jenkins-Marsh

    The Townsville Hospital, Townsville, Australia

  • Siew C Chia

    Palliative Medicine Department, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore

  • Phillip Good

    Department of Palliative Care, St Vincent's Private Hospital, Brisbane, Australia

    Department of Palliative and Supportive Care, Mater Health Services, Brisbane, Australia

Contributions of authors

William Syrmis: formulated question, drafted and wrote final protocol, searched for studies, reviewed titles and abstracts, retrieved articles, assessed article quality, drafted and wrote review.

Russell Richard: provided review and general advice on the protocol, reviewed titles and abstracts, assessed article quality, performed critical revision of review.

Sue Jenkins‐Marsh: drafted protocol, reviewed titles and abstracts, assessed article quality, performed critical revision of review.

Siew Chin Chia: provided review and general advice on the protocol, reviewed titles and abstracts, assessed article quality, performed critical revision of review.

Phillip Good: formulated question, drafted protocol, reviewed titles and abstracts, retrieved articles, assessed article quality, performed critical revision of review.

All the authors agreed on the final version.

Declarations of interest

  • William Syrmis: none known; WS is a Palliative Care specialist and manages patients with inoperable malignant bowel obstructions. He will be an investigator in an open label pilot study of oral water soluble contrast (Gastrografin) in addition to conservative medical management for the resolution of malignant bowel obstruction in adult patients to take place in late 2017.

  • Russell Richard: none known; RR is a Palliative Care specialist and manages patients with inoperable malignant bowel obstructions. He will be an investigator in an open label pilot study of oral water soluble contrast (Gastrografin) in addition to conservative medical management for the resolution of malignant bowel obstruction in adult patients to take place in late 2017.

  • Sue Jenkins‐Marsh: none known.

  • Siew Chin Chia: none known; SC is a Palliative Care physician and manages patients with inoperable malignant bowel obstructions.

  • Phillip Good: none known; PG is a Palliative Care physician and manages patients with inoperable malignant bowel obstructions. He will be an investigator in an open label pilot study of oral water soluble contrast (Gastrografin) in addition to conservative medical management for the resolution of malignant bowel obstruction in adult patients to take place in late 2017.

Acknowledgements

We thank Joanne Abbott, the Information Specialist for the Cochrane Pain, Palliative and Supportive Care Review Group for assisting to develop the search strategy.

Cochrane Review Group funding acknowledgement: this project was supported by the National Institute for Health Research, via Cochrane Infrastructure funding to the Cochrane Pain, Palliative and Supportive Care Review Group (PaPaS). The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the Systematic Reviews Programme, NIHR, NHS or the Department of Health.

Version history

Published

Title

Stage

Authors

Version

2018 Mar 07

Oral water soluble contrast for malignant bowel obstruction

Review

William Syrmis, Russell Richard, Sue Jenkins-Marsh, Siew C Chia, Phillip Good

https://doi.org/10.1002/14651858.CD012014.pub2

2015 Dec 22

Oral water soluble contrast for malignant bowel obstruction

Protocol

William Syrmis, Russell Richard, Sue Jenkins‐Marsh, Siew C Chia, Phillip Good

https://doi.org/10.1002/14651858.CD012014

Notes

A restricted search in March 2020 did not identify any potentially relevant eligible studies likely to change the conclusions. Therefore, this review has now been stabilised following discussion with the authors and editors. The review will be re‐assessed for updating in two years. If appropriate, we will update the review before this date if new evidence likely to change the conclusions is published, or if standards change substantially which necessitate major revisions.

Keywords

MeSH

Medical Subject Headings (MeSH) Keywords

Medical Subject Headings Check Words

Adult; Humans;

PICO

Population
Intervention
Comparison
Outcome

El uso y la enseñanza del modelo PICO están muy extendidos en el ámbito de la atención sanitaria basada en la evidencia para formular preguntas y estrategias de búsqueda y para caracterizar estudios o metanálisis clínicos. PICO son las siglas en inglés de cuatro posibles componentes de una pregunta de investigación: paciente, población o problema; intervención; comparación; desenlace (outcome).

Para saber más sobre el uso del modelo PICO, puede consultar el Manual Cochrane.

Study flow diagram.

Figuras y tablas -
Figure 1

Study flow diagram.

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'Risk of bias' summary: review authors' judgements about each risk of bias item for each included study.

Figuras y tablas -
Figure 2

'Risk of bias' summary: review authors' judgements about each risk of bias item for each included study.

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Summary of findings 1. Summary of findings

Oral Water Soluble Contrast compared with Placebo for Malignant Bowel Obstruction

Patient or population: Adults 18 yrs and over with malignant bowel obstruction (MBO) as defined by the International Conference on MBO, with no indication for other treatments e.g. surgery, endoscopy, etc

Settings: Hospital inpatients

Intervention: 100 mL of gastrografin administered orally

Comparison: Placebo (100m L of distilled water flavoured with aniseed oil in order to mimic the taste and smell of gastrografin)

Outcomes

No of Participants
(studies)

Quality of the evidence
(GRADE)

Comments

1. The ability of OWSC, when seen to reach the colon on follow‐up imaging, to predict the likelihood of malignant small bowel obstruction resolving with conservative treatment alone (diagnostic).

no data

no data

no data

2. The rate of resolution of MBO with medical management only in patients receiving OWSC compared with those not receiving it (therapeutic).

no data

no data

no data

3. Gastrointestinal adverse effects (increased abdominal pain, nausea, vomiting).

9

(1)

⊕⊝⊝⊝
very low1

Although they reported that "no issues regarding safety or tolerability of either gastrografin or placebo were identified", no data were actually reported.

4. Extra‐abdominal complications (aspiration pneumonia, hypersensitivity reactions).

9

(1)

⊕⊝⊝⊝
very low1

Although they reported that "no issues regarding safety or tolerability of either gastrografin or placebo were identified", no data were actually reported.

5. Length of hospital stay.

no data

no data

no data

6. Time from administration of OWSC to resolution of MBO.

no data

no data

no data

7. Survival time from onset of inoperable MBO until death.

no data

no data

no data

GRADE Working Group grades of evidence
High quality: we are very confident that the true effect lies close to that of the estimate of the effect;
Moderate quality: we are moderately confident in the effect estimate; the true effect is likely to be close to the estimate of effect, but there is a possibility that it is substantially different;
Low quality: our confidence in the effect estimate is limited; the true effect may be substantially different from the estimate of the effect;
Very low quality: we have very little confidence in the effect estimate; the true effect is likely to be substantially different from the estimate of effect.

1 Downgraded twice for serious limitations to study quality (high risk of selective reporting and of attrition bias) and downgraded once for imprecision (sparse data).

OWSC = oral water soluble contrast
Figuras y tablas -
Summary of findings 1. Summary of findings
Ir a la tabla de la revisión