The aim of this study was to investigate the effect of oral lactulose for pediatric patients with complicated appendicitis, who underwent appendectomy. Oral lactulose was widely used for gastrointestinal function regulation. However, clinical benefit for oral lactulose regarding its effects on recent postoperative gastrointestinal (GI) recovery and long term adhesive small bowel obstruction (ASBO) incidence, especially in the postoperative pediatric population has not yet defined. A total of 525 pediatric patients with complicated appendicitis underwent appendectomy were retrospectively reviewed. Among them, 317 cases were subjected to oral lactulose management and 208 patients without, served as control. Propensity score 1:1 matching was carried out to adjust for any potential baseline variables. In 189 paired patients, clinical outcomes, including gastrointestinal recovery variables, incidence of ABSO, as well as adverse events, were compared according to the oral lactulose administration or not. Patients who received oral lactulose administration achieved early gastrointestinal function recovery, including, first bowel movement (Risk ratio [RR], 1.34; 95% confidence interval [CI] 1.02–2.63, p = 0.005) and first solid feeding (RR, 1.26; 95% CI, 1.01–1.92, p = 0.012). A lower occurrence of ASBO (OR, 0.47; 95% CI, 0.25–0.87; p = 0.011) and lower constipation (Odds ratio [OR], 0.25; 95% CI, 0.13–0.46; p < 0.001), were noted in patients received oral lactulose than in patients without. Furthermore, significantly fewer patients required readmission (OR, 0.56; 95% CI, 0.32–0.99; p = 0.031) and reoperation (OR, 0.29; 95% CI, 0.09–0.92; p = 0.022) in the patients who received oral lactulose administration. Beneficial effects of oral lactulose administration in pediatric patients undergone appendectomy were indicated, such as accelerating gastrointestinal function recovery, reducing the postoperative incidence of ASBO and constipation, so reduced readmission and reoperation.

中文翻译：

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倾向评分匹配分析口服乳果糖对复杂性阑尾炎患者术后护理的临床价值

这项研究的目的是研究口服乳果糖对小儿阑尾炎并发阑尾炎的影响。口服乳果糖广泛用于胃肠功能调节。然而，关于口服乳果糖对近期术后胃肠道（GI）恢复和长期粘连性小肠梗阻（ASBO）发生率的影响，尤其是在术后儿科人群中，其临床益处尚不确定。回顾性分析了525例小儿并发阑尾炎患者的阑尾切除术。其中317例接受口服乳果糖治疗，208例未接受口服乳果糖治疗，作为对照。倾向得分1：1匹配以调整任何潜在的基线变量。在189例配对患者中，临床结果 包括胃肠道恢复变量，ABSO发生率以及不良事件，根据是否口服乳果糖进行比较。口服乳果糖的患者可实现胃肠功能的早期恢复，包括首次排便（风险比[RR]为1.34； 95％置信区间[CI] 1.02–2.63，p = 0.005）和首次固体喂养（RR为1.26； 100％首次服用固体食物）。 95％CI，1.01–1.92，p = 0.012）。研究发现，ASBO的发生率较低（OR为0.47； 95％CI为0.25–0.87； p = 0.011）和便秘程度较低（几率[OR]为0.25； 95％CI为0.13–0.46； p <0.001）。接受口服乳果糖的患者比未接受口服乳果糖的患者多。此外，需要再入院（OR，0.56； 95％CI，0.32-0.99； p = 0.031）和再次手术（OR，0.29； 95％CI，0.09-0.92； p = 0）的患者明显减少。022）接受口服乳果糖的患者。结果表明，口服乳果糖对小儿阑尾切除术患者有益，如加速胃肠功能恢复，减少ASBO和便秘的发生率，从而减少再入院和再次手术。