The effect of early mobilization on constipation after abdominal surgery: A systematic review: The effect mobilization on constipation

İsmail  Öztaş; Ayla  Yava; Aynur  Koyuncu

doi:10.28982/josam.7832

Authors

İsmail Öztaş Hakkari University, Vocational School of Health Services, Hakkari, Turkey https://orcid.org/0000-0001-7890-8199
Ayla Yava Hasan Kalyoncu University, Faculty of Health Sciences, Department of Nursing, Gaziantep, Turkey https://orcid.org/0000-0003-3468-6779
Aynur Koyuncu Hasan Kalyoncu University, Faculty of Health Sciences, Department of Nursing, Gaziantep, Turkey https://orcid.org/0000-0003-3486-458X

DOI:

https://doi.org/10.28982/josam.7832

Keywords:

Abdominal surgery, early mobilization, constipation, planned mobilization

Abstract

Background/Aim: Constipation can occur after abdominal procedures. In this study, we investigated whether early mobilization after abdominal surgery is effective for treating constipation.

Methods: We conducted a systematic review of studies implementing early and planned mobilization after abdominal surgical procedures. We extracted studies published from 2012–2022 from six electronic databases: PubMed, Google Scholar, Science Direct, Cochrane, TürkMedline, and Ulakbim. The data were collected by two reviewers following a pre-designed subtraction form. We made use of narrative synthesis when presenting our results.

Results: We examined 10 articles that satisfied the inclusion criteria; patients underwent a cesarean section in four studies, bariatric surgery (gastric bypass) in one study, liver resection in one study, radical cystectomy in two studies, cholecystectomy in one study, and a kidney transplant in one study. The studies were characterized by differences in the early mobilization programs applied to patients after abdominal surgery. In two of the studies, the patients were mobilized accordingly to daily step goals; in five studies only early stimulation and walking attempts were utilized. In three of the studies, the patients were mobilized within the scope of mobilization programs prepared in detail after surgery, and the targets were determined in terms of distance walked. All of the studies stipulated that physical activity should gradually increase over time.

Conclusion: Early and planned mobilization programs applied after surgery had positive effects on first gas/first stool output time, the severity of abdominal distension, the occurrence of nausea/vomiting, and the onset of oral intake.

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References

İzveren ÖA, Dal Ü. The Early Period Complications in Patients who were Performed Abdominal Surgery Intervention and the Nursing Practices for These Complications. Hacettepe University Faculty of Health Sciences Nursing Journal. 2011;18:36-46.

Erdil F, Özhan-Elbaş N. Surgical Diseases Nursing. Ankara: Aydoğdu Ofset; 2001. s.456-505.

Miedema BW, Johnson OJ. Methods for decreasing postoperative gut dysmotility. The Lancet Oncology. 2003;4:365-72.

Brenner ZA. Preventing postoperative complications. Nursing Management. 2000;31(12):17-22.

Çilingir D, Bayraktar N. Day Surgery Process and Nursing Care. Hacettepe University School of Nursing Journal. 2006;13(1):69-81.

Klingman L, Bowel Elimination. Fundamentals of Nursing. Potter PA, Pery AG Eds. 7th Edition, Canada: Mosby Elseiver. 2009;1174-200, 1217-8.

Phipps WJ, Cassmeyer VL, Sandus JK, Lehman MK Medical-Surgical Nursing Concepts and Clinical Practice, 5th Edition, Mosby. 1995;1524-8.

Büyükyılmaz F, Şendir M. Cerrahi hastalarında barsak boşaltımı sorunlarına yönelik hemşirelik bakımı. Maltepe Üniversitesi Hemşirelik Bilim ve Sanatı Dergisi. 2009;2(1):74-81.

Erkal-İlhan S. Perioperatif Bakım. N. Akbayrak, S. Erkal-İlhan, G. Akçel, A. Albayrak Eds. Hemşirelik Bakım Planları (Dahiliye-Cerrahi Hemşireliği ve Psiko-sosyal Boyut). Ankara:Alter Yayıncılık; 2007. pp. 631-647.

Hicks A. The prevention and management of constipation. Journal of Orthopaedic Nursing. 20015:208-11.

Hsieh C. Treatment of constipation in older adults. American Family Physician. 2005;72(11):2277-84.

Lassen K, Soop M, Nygren J, Cox PB, Hendry PO, Spies C, et al. Consensus review of optimal perioperative care in colorectal surgery: Enhanced Recovery After Surgery (ERAS) Group recommendations. Arch Surg. 2009;144(10):961–9.

Gustafsson UO, Scott MJ, Hubner M, Nygren J, Demartines N, Francis N, et al. Guidelines for Perioperative Care in Elective Colorectal Surgery: Enhanced Recovery After Surgery (ERAS®) Society Recommendations: 2018. World J Surg. 2019;43(3):659-695. doi: 10.1007/s00268-018-4844-y

Mathiasen MC, Andersen RM, Schmidt DS, Thomsen T, Vinther A, Danielsen AK. Early mobilisation after colorectal surgery: a qualitative study. Gastrointestinal Nursing. 2021;19(3):30-36. doi: 10.12968/gasn.2021.19.3.30.

Liebermann M, Awad M, Dejong M, Rivard C, Sinacore J, Brubaker L. Ambulation of hospitalized gynecologic surgical patients: a randomized controlled trial. Obstet Gynecol. 2013;121(3):533-7. doi: 10.1097/AOG.0b013e318280d50a.

Nishijima M, Baba H, Murotani K, Tokai R, Watanabe T, Hirano K, et al. Early ambulation after general and digestive surgery: a retrospective single-center study. Langenbeck's Archives of Surgery. 2020;405(5):613-22. doi: 10.1007/s00423-020-01925-9.

Burgess LC, Wainwright TW. What Is the Evidence for Early Mobilisation in Elective Spine Surgery? A Narrative Review. Healthcare (Basel). 2019;7(3):92. Published 2019 Jul 18. doi:10.3390/healthcare7030092

Grass F, Pache B, Martin D, Addor V, Hahnloser D, Demartines N, et al. Feasibility of early postoperative mobilisation after colorectal surgery: a retrospective cohort study. Int J Surg. 2018;56:161-6.

Wiklund M, Sundqvist E, Olsen MF. Physical activity in the immediate postoperative phase in patients undergoing Roux-en-Y gastric bypass-a randomized controlled trial. Obes Surg. 2015;25:2245-50.

Kalisch JB, Lee S, Dabney WB. Outcomes of inpatient mobilization: a literature review. J Clin Nurs. 2013;23:1-16.

Currier D, TeKolste D, Wheatley MA. Why day zero matters in early ambulation for postoperative patients: an evidence-based project. Virginia Henderson Global Nursing e-Repository, 2018. Available from: https://sigma.nursingrepository.org/handle/10755/624140 Accessed: 8 December 2022.

Doherty-King B, Yoon JY, Pecanac K, Brown R, Mahoney J. Frequency and duration of nursing care related to older patient mobility. J Nurs Scholarsh. 2013;46:20-7.

Wahyuni S, Wahyuni AS, Tarigan R, Syarifah S. Effect of early ambulation to peristaltic activity of abdominal post-operative patients in Medan city hospital, Indonesia. J Phys. 2019;1317:1-5.

Vather R, Trivedi S, Bissett I. Defining postoperative ileus: results of a systematic review and global survey. J Gastrointest Surg. 2013;17(5):962-72. doi: 10.1007/s11605-013-2148-y

Chapman SJ, Thorpe G, Vallance AE, Harji DP, Lee MJ, Fearnhead NS. Systematic review of definitions and outcome measures for return of bowel function after gastrointestinal surgery. BJS Open. 2018;3(1):1-10. Published 2018 Oct 1. doi: 10.1002/bjs5.102

Sindell S, Causey MW, Bradley T, Poss M, Moonka R, Thirlby R. Expediting return of bowel function after colorectal surgery. Am J Surg. 2012;203(5):644-8. doi: 10.1016/j.amjsurg.2011.12.007.

Hu Y, McArthur A, Yu Z. Early postoperative mobilization in patients undergoing abdominal surgery: a best practice implementation project. JBI Database System Rev Implement Rep. 2019;17(12):2591-611. doi: 10.11124/JBISRIR-D-19-00063

Kaur H, Kaur S, Sikka P. A quasi-experimental study to assess the effectiveness of early ambulation in post-operative recovery among post-caesarean mothers admitted in selected areas of Nehru Hospital, PGIMER, Chandigarh. Nursing & Midwifery Research Journal. 2015;11(1):33-44. doi:10.1177/0974150X20150104

Terzioğlu F, Şimsek S, Karaca K, Sariince N, Altunsoy P. Salman MC. Multimodal Interventions (Chewing Gum, Early Oral Hydration and Early Mobilisation) on the Intestinal Motility Following Abdominal Gynaecologic Surgery. Journal of Clinical Nursing. 2013;22:9-10. doi: 10.1111/jocn.12172

Kibler VA, Hayes RM, Johnson DE, Anderson LW, Just SL, Wells NL. Cultivating quality: early postoperative ambulation: back to basics. Am J Nurs. 2012;112(4):63-9. doi: 10.1097/01.NAJ.0000413460.45487.ea

Tazreean R, Nelson G, Twomey R. Early mobilization in enhanced recovery after surgery pathways: current evidence and recent advancements. J Comp Eff Res. 2022 Feb;11(2):121-9. doi: 10.2217/cer-2021-0258. Epub 2022 Jan 20. PMID: 35045757.

Sahin E, Terzioglu F. The Effect of Gum Chewing, Early Oral Hydration, and Early Mobilization on Intestinal Motility After Cesarean Birth. Worldviews Evid Based Nurs. 2015;12(6):380-8. doi: 10.1111/wvn.12125

Ni CY, Wang ZH, Huang ZP, Zhou H, Fu LJ, Cai H, et al. Early enforced mobilization after liver resection: A prospective randomized controlled trial. Int J Surg. 2018;54(Pt A):254-8. doi: 10.1016/j.ijsu.2018.04.060

Abd-Elhamed AG, Osman MA, Mobarak AA, Hussien AA. Efficacy of early mobilization on bowel motility for children after abdominal surgery. Assiut Sci Nurs J. 2019;7:78-89.

Barai D, Vahitha S. Effectiveness of early ambulation on post-operative recovery among primiparous post cesarean mothersa randomized control trial. Int J Sci Res. 2019;8:3-6.

Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021;372:n71. doi: 10.1136/bmj.n71

Aldemir, K., Aydın Sayılan, A. Effect of a mobilization program administered after open cholecystectomy on sleep duration and several other clinical variables. Cukurova Medical Journal. 2020:613-20.

Dube JV, Kshirsagar NS. Effect of planned early recommended ambulation technique on selected post caesarean biophysiological health parameters. J Krishna Inst Medical Sci Univ. 2014;3:41-8.

Hassan EH, El-Sadek ANE, Ali LAH. Effect of three different nursing interventions on intestinal motility and women’s satisfaction post-cesarean section birth. Am J Nurs Res. 2019;7:932-41.

Herman A, Santoso B, Yunitasari B. The Effect of Early Mobilization on Intestinal Peristaltics in Patients after a Cesarean Section in Kendari City Hospital. Jurnal Ners. 2019, 14(3si),288-291. doi: 10.20473/jn.v14i3(si).17148

Jensen BT, Jensen JB, Laustsen S, Petersen AK, Søndergaard I, Borre M. Multidisciplinary rehabilitation can impact on health-related quality of life outcome in radical cystectomy: secondary reported outcome of a randomized controlled trial. Journal of multidisciplinary healthcare. 2014;7:301–11. doi: 10.2147/JMDH.S62172

National Guideline Centre (UK). Evidence review for very early mobilisation: Stroke and transient ischaemic attack in over 16s: diagnosis and initial management: Evidence review F. London: National Institute for Health and Care Excellence (NICE); 2019 May. PMID: 35167209. Available from: https://www.nice.org.uk/guidance/ng128/resources/stroke-and-transient-ischaemic-attack-in-over-16s-diagnosis-andinitial-management-pdf-66141665603269 Accessed: 12 December 2022.

Zhu Q, Yang J, Zhang Y, Ni X, Wang P. Early mobilization intervention for patient rehabilitation after renal transplantation. American journal of translational research. 2021;13(6):7300–5.