Eur J Pediatr Surg 2023; 33(04): 259-270
DOI: 10.1055/s-0042-1745779
Review Article

Systematic Review of Definitions and Outcome Measures for Postoperative Ileus and Return of Bowel Function after Abdominal Surgery in Children

1   Department of Paediatric Surgery, Emma Children's Hospital, Amsterdam University Medical Center, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
2   Tytgat Institute for Liver and Intestinal Research, Amsterdam University Medical Center, University of Amsterdam, the Netherlands
Igor J. Shirinskiy
1   Department of Paediatric Surgery, Emma Children's Hospital, Amsterdam University Medical Center, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
Gijsbert D. Musters
1   Department of Paediatric Surgery, Emma Children's Hospital, Amsterdam University Medical Center, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
Wouter J. de Jonge
2   Tytgat Institute for Liver and Intestinal Research, Amsterdam University Medical Center, University of Amsterdam, the Netherlands
3   Department of General, Visceral, Thoracic and Vascular Surgery, University Hospital Bonn, Bonn, Germany
Ralph de Vries
4   Medical Library, Vrije Universiteit, Amsterdam, the Netherlands
L.W. Ernest van Heurn
1   Department of Paediatric Surgery, Emma Children's Hospital, Amsterdam University Medical Center, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
2   Tytgat Institute for Liver and Intestinal Research, Amsterdam University Medical Center, University of Amsterdam, the Netherlands
Joep P.M. Derikx
1   Department of Paediatric Surgery, Emma Children's Hospital, Amsterdam University Medical Center, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
2   Tytgat Institute for Liver and Intestinal Research, Amsterdam University Medical Center, University of Amsterdam, the Netherlands
› Author Affiliations
Funding None.


This review aims to objectify which definitions and outcome measures are used for the return of bowel function and postoperative ileus in children. PubMed and Embase were systematically searched from inception to December 17, 2020. Prospective studies conducted in children (aged 0–18 years) undergoing gastrointestinal surgery which reported on definitions and/or outcome measures for post-operative ileus or return of bowel function were evaluated. Definitions and outcome measures were extracted. From 4,027 references, 71 articles were included. From the 17 articles mentioning postoperative ileus, 8 (47%) provided a definition. In total, 34 outcome measures were used and 12 were unique. “Abdominal distension” was the most reported (41%) measure. In 41%, the outcome measures only described the return of gastric motility, while 18% described the return of intestinal motility. The return of bowel function was mentioned in 67 articles, none provided a definition. In total, 133 outcome measures were used and 37 were unique. Time to oral intake was the most reported (14%) measure. In 49%, the outcome measures only described the return of gastric motility, while 10% described the return of intestinal motility. High variation in definitions and outcome measures has limited the generalizability of research into postoperative bowel function in children. Without standardization, it will be impossible to compare research results and evaluate treatments. In children, the return of gastric motility seemingly should get more focus compared to adults. Therefore, we believe that a definition of postoperative ileus with an accompanying core outcome set, developed by a multidisciplinary team, specifically for children is required.

Publication History

Received: 27 October 2021

Accepted: 11 February 2022

Article published online:
15 September 2022

© 2022. Thieme. All rights reserved.

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