Meta-analysis of Randomized Studies Evaluating Chewing Gum to Enhance Postoperative Recovery Following Colectomy

Purkayastha, Sanjay; Tilney, H. S.; Darzi, Ara; Tekkis, Paris

doi:10.1001/archsurg.143.8.788

Cited by 84 publications

(70 citation statements)

References 35 publications

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“…Although there are relatively low patient numbers and a significant heterogeneity of studies, chewing gum offers significant benefits by reducing the time to pass flatus and the time until first bowel movement. [79][80][81][82] The use of bowel segments in the reconstruction of the urinary tract after cystectomy lead Kouba and colleagues to examine the use of chewing gum following cystectomy. 83 The time to flatus was shorter in patients who received gum compared with controls (2.4 vs. 2.9 days).…”

Section: Prevention Of Prolonged Postoperative Ileusmentioning

confidence: 99%

Enhanced recovery after surgery (ERAS) protocols: Time to change practice?

Melnyk

Casey

Black

et al. 2013

CUAJ

275

120

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Radical cystectomy with pelvic lymph node dissection remains the standard treatment for patients with muscle invasive bladder cancer. Despite improvements in surgical technique, anesthesia and perioperative care, radical cystectomy is still associated with greater morbidity and prolonged in-patient stay after surgery than other urological procedures. Enhanced recovery after surgery (ERAS) protocols are multimodal perioperative care pathways designed to achieve early recovery after surgical procedures by maintaining preoperative organ function and reducing the profound stress response following surgery. The key elements of ERAS protocols include preoperative counselling, optimization of nutrition, standardized analgesic and anesthetic regimens and early mobilization. Despite the significant body of evidence indicating that ERAS protocols lead to improved outcomes, they challenge traditional surgical doctrine, and as a result their implementation has been slow.The present article discusses particular aspects of ERAS protocols which represent fundamental shifts in surgical practice, including perioperative nutrition, management of postoperative ileus and the use of mechanical bowel preparation.

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Section: Prevention Of Prolonged Postoperative Ileusmentioning

confidence: 99%

Enhanced recovery after surgery (ERAS) protocols: Time to change practice?

Melnyk

Casey

Black

et al. 2013

CUAJ

275

120

View full text Add to dashboard Cite

show abstract

“…Purkayastha and coworkers 31 reported results of a meta-analysis of pooled data extracted from 158 persons participating in 5 RCT that evaluated the effect of chewing gum on the duration of POI, including 2 studies that enrolled subjects undergoing formation of an intestinal stoma. All of the trials incorporated into this systematic review [25][26][27][28]30 were also included in the analysis reported by Noble's group.…”

Section: Question: Does Chewing Gum Shorten the Duration Of Poi In Pamentioning

confidence: 99%

Does Chewing Gum Shorten the Duration of Postoperative Ileus in Patients Undergoing Abdominal Surgery and Creation of a Stoma?

Hocevar

Robinson

Gray

2010

Journal of Wound, Ostomy &Amp; Continence Nursing

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Current best evidence suggests that chewing gum should be offered to selected patients with the intent of decreasing postoperative ileus. A careful nursing assessment of the patient's mental status, aspiration risk, and dentition is needed before initiating the intervention. In addition, further research is needed to develop more clearly defined parameters for chewing gum including frequency and duration of chewing and its use in patients with nasogastric tubes.

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“…The use of chewing gum has emerged as a further, new, novel and simple strategy for preventing postoperative ileus. Several studies have reported on the beneficial effect of using chewing gum after surgery to limit the incidence of ileus [6][7][8] . This study aimed to determine whether gum chewing in the immediate postoperative period facilitates a return to bowel function after cesarean section.…”

Section: Influence Of Gum Chewing On Postoperative Bowel Activitymentioning

confidence: 99%

Influence of Gum Chewing on Postoperative Bowel Activity after Cesarean Section

Kafalı

Duvan

Gözdemir

et al. 2009

Gynecol Obstet Invest

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Objective: To assess the effects of gum chewing on postoperative bowel function after cesarean section. Material and Methods: Women who underwent cesarean section were randomized to either a gum-chewing group (n = 74) or a non-gum-chewing group (n = 76). The two groups were compared with respect to the return of bowel activity, postoperative analgesic and antiemetic drug requirement and postoperative hospital stay. Results: Bowel sounds appeared in a significantly shorter duration of time in the study group, the mean being 5.9 h as compared to 6.7 h in the control group (p < 0.01). The first passage of flatus postoperatively was 22.4 h in the gum-chewing group and 31 h in the control group (p < 0.001). The total length of hospital stay was shorter in the gum-chewing group (2.1 days) than in the control group (2.3 days), but it was not statistically significant (p > 0.05). Postoperative analgesic requirement in both groups was similar, but the postoperative antiemetic need in the gum-chewing group was lower than in the control group (p < 0.01). Conclusion: On the basis of the tolerability and results on bowel function, gum chewing provides a simple method for early recovery of bowel function after cesarean section.

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Meta-analysis of Randomized Studies Evaluating Chewing Gum to Enhance Postoperative Recovery Following Colectomy

Abstract: To compare outcomes following abdominal surgery with or without the use of chewing gum in the early postoperative period.

Cited by 84 publications

References 35 publications

Enhanced recovery after surgery (ERAS) protocols: Time to change practice?

Enhanced recovery after surgery (ERAS) protocols: Time to change practice?

Does Chewing Gum Shorten the Duration of Postoperative Ileus in Patients Undergoing Abdominal Surgery and Creation of a Stoma?

Influence of Gum Chewing on Postoperative Bowel Activity after Cesarean Section

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