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Erschienen in: World Journal of Surgery 4/2021

05.01.2021 | Surgery in Low and Middle Income Countries

Role of Chewing Gum in Reducing Postoperative Ileus after Reversal of Ileostomy: A Randomized Controlled Trial

verfasst von: Samiullah Bhatti, Yusra Jahangir Malik, Shabbar Hussain Changazi, Usman Ali Rahman, Awais Amjad Malik, Usman Ismat Butt, Muhammad Umar, Muhammad Waris Farooka, Mahmood Ayyaz

Erschienen in: World Journal of Surgery | Ausgabe 4/2021

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Abstract

Background

Postoperative ileus is one of the most prevalent and troublesome problems after any elective or emergency laparotomy. Gum chewing has emerged as a new and simple modality for decreasing postoperative ileus. The aim of this study was to determine the effectiveness of chewing gum in reducing postoperative ileus in terms of passage of flatus and total length of hospital stay.

Patients and methods

This single-blinded, randomized clinical trial was conducted in department of surgery, Services Hospital Lahore, between November 2013 and November 2015. The patients were divided into two groups: chewing gum (Group A) and no chewing gum (Group B). Starting 6 h after the operation, Group A patients were asked to chew gum for 30 min every 8 h; bowel sounds, passage of flatus and total length of hospital stay were noted. Outcome measures such as passage of flatus and total length of hospital stay in patients undergoing reversal of ileostomy were compared using t-test.

Results

Mean age of the patients in Group A was 26.12 (± 7.1) years and in Group B was 28.80 (± 10.5) years. There were 25 males (50%) and 25 females (50%) in Group A. In Group B, there were 29 males (58%) and 21 females (42%). Mean BMI in Group A was 23.5 (± 5.3), and in Group B was 21.4 (± 4.6). The mean time to pass flatus was noted to be significantly shorter, 18.36 (± 8.43) hours, in the chewing group (Group A), whereas in the no chewing gum group (Group B), it was 41.16 (± 6.14) hours (p value < 0.001). The mean length of hospital stay was significantly shorter 84 (± 8.3) hours in the chewing gum group (Group A) as compared to 107.04 (± 6.4) hours in the no chewing gum group (Group B) (p value 0.000).

Conclusion

It is concluded that postoperative chewing of gum after the reversal of ileostomy is accompanied with a significantly shorter time to passage of flatus and shorter length of hospital stay.
Literatur
1.
Zurück zum Zitat Barletta JF, Senagore AJ (2014 Aug 1) Reducing the burden of postoperative ileus: evaluating and implementing an evidence-based strategy. World J Surg 38(8):1966–1977CrossRef Barletta JF, Senagore AJ (2014 Aug 1) Reducing the burden of postoperative ileus: evaluating and implementing an evidence-based strategy. World J Surg 38(8):1966–1977CrossRef
2.
Zurück zum Zitat Tandeter H (2009 Jan 1) Hypothesis: hexitols in chewing gum may play a role in reducing postoperative ileus. Med Hypotheses 72(1):39–40CrossRef Tandeter H (2009 Jan 1) Hypothesis: hexitols in chewing gum may play a role in reducing postoperative ileus. Med Hypotheses 72(1):39–40CrossRef
3.
Zurück zum Zitat Delaney CP (2004 Oct) Clinical perspective on postoperative ileus and the effect of opiates. Neurogastroenterol Motil 16:61–66CrossRef Delaney CP (2004 Oct) Clinical perspective on postoperative ileus and the effect of opiates. Neurogastroenterol Motil 16:61–66CrossRef
4.
Zurück zum Zitat Miedema BW, Johnson JO (2003 Jun 1) Methods for decreasing postoperative gut dysmotility. Lancet Oncol 4(6):365–372CrossRef Miedema BW, Johnson JO (2003 Jun 1) Methods for decreasing postoperative gut dysmotility. Lancet Oncol 4(6):365–372CrossRef
5.
Zurück zum Zitat Kurz A, Sessler DI (2003 Apr 1) Opioid-induced bowel dysfunction. Drugs 63(7):649–671CrossRef Kurz A, Sessler DI (2003 Apr 1) Opioid-induced bowel dysfunction. Drugs 63(7):649–671CrossRef
6.
Zurück zum Zitat Asao T, Kuwano H, Nakamura JI, Morinaga N, Hirayama I, Ide M (2002 Jul 1) Gum chewing enhances early recovery from postoperative ileus after laparoscopic colectomy. J Am Coll Surg 195(1):30–32CrossRef Asao T, Kuwano H, Nakamura JI, Morinaga N, Hirayama I, Ide M (2002 Jul 1) Gum chewing enhances early recovery from postoperative ileus after laparoscopic colectomy. J Am Coll Surg 195(1):30–32CrossRef
7.
Zurück zum Zitat Cavuşoğlu YH, Azılı MN, Karaman A, Aslan MK, Karaman I, Erdoğan D, Tütün Ö (2009 Jun) Does gum chewing reduce postoperative ileus after intestinal resection in children? A prospective randomized controlled trial. Eur J Pediatr Surg 19(03):171–173CrossRef Cavuşoğlu YH, Azılı MN, Karaman A, Aslan MK, Karaman I, Erdoğan D, Tütün Ö (2009 Jun) Does gum chewing reduce postoperative ileus after intestinal resection in children? A prospective randomized controlled trial. Eur J Pediatr Surg 19(03):171–173CrossRef
8.
Zurück zum Zitat Choi H, Kim JH, Park JY, Ham BK, Shim JS, Bae JH (2014 Mar) Gum chewing promotes bowel motility after a radical retropubic prostatectomy. Asia-Pac J Clin Oncol 10(1):53–59CrossRef Choi H, Kim JH, Park JY, Ham BK, Shim JS, Bae JH (2014 Mar) Gum chewing promotes bowel motility after a radical retropubic prostatectomy. Asia-Pac J Clin Oncol 10(1):53–59CrossRef
9.
Zurück zum Zitat Ertas IE, Gungorduk K, Ozdemir A, Solmaz U, Dogan A, Yildirim Y (2013 Oct 1) Influence of gum chewing on postoperative bowel activity after complete staging surgery for gynecological malignancies: a randomized controlled trial. Gynecol Oncol 131(1):118–122CrossRef Ertas IE, Gungorduk K, Ozdemir A, Solmaz U, Dogan A, Yildirim Y (2013 Oct 1) Influence of gum chewing on postoperative bowel activity after complete staging surgery for gynecological malignancies: a randomized controlled trial. Gynecol Oncol 131(1):118–122CrossRef
10.
Zurück zum Zitat McCormick JT, Garvin R, Caushaj P, Simmang C, Gregorcyk S, Huber P, Odom C, Downs M, Read T, Papaconstantinou H (2005 Sep 1) The effects of gum-chewing on bowel function and hospital stay after laparoscopic vs open colectomy: a multi-institution prospective randomized trial. J Am Coll Surg 201(3):S66–S67CrossRef McCormick JT, Garvin R, Caushaj P, Simmang C, Gregorcyk S, Huber P, Odom C, Downs M, Read T, Papaconstantinou H (2005 Sep 1) The effects of gum-chewing on bowel function and hospital stay after laparoscopic vs open colectomy: a multi-institution prospective randomized trial. J Am Coll Surg 201(3):S66–S67CrossRef
11.
Zurück zum Zitat Noble EJ, Harris R, Hosie KB, Thomas S, Lewis SJ (2009 Jan 1) Gum chewing reduces postoperative ileus? A systematic review and meta-analysis. Int J Surg 7(2):100–105CrossRef Noble EJ, Harris R, Hosie KB, Thomas S, Lewis SJ (2009 Jan 1) Gum chewing reduces postoperative ileus? A systematic review and meta-analysis. Int J Surg 7(2):100–105CrossRef
12.
Zurück zum Zitat Chan MK, Law WL (2007 Dec 1) Use of chewing gum in reducing postoperative ileus after elective colorectal resection: a systematic review. Dis Colon Rectum 50(12):2149–2157CrossRef Chan MK, Law WL (2007 Dec 1) Use of chewing gum in reducing postoperative ileus after elective colorectal resection: a systematic review. Dis Colon Rectum 50(12):2149–2157CrossRef
13.
Zurück zum Zitat Vásquez W, Hernández AV, Garcia-Sabrido JL (2009 Apr 1) Is gum chewing useful for ileus after elective colorectal surgery? A systematic review and meta-analysis of randomized clinical trials. J Gastrointestinal Surg 13(4):649–656CrossRef Vásquez W, Hernández AV, Garcia-Sabrido JL (2009 Apr 1) Is gum chewing useful for ileus after elective colorectal surgery? A systematic review and meta-analysis of randomized clinical trials. J Gastrointestinal Surg 13(4):649–656CrossRef
14.
Zurück zum Zitat Fitzgerald JE, Ahmed I (2009 Dec 1) Systematic review and meta-analysis of chewing-gum therapy in the reduction of postoperative paralytic ileus following gastrointestinal surgery. World J Surg 33(12):2557–2566CrossRef Fitzgerald JE, Ahmed I (2009 Dec 1) Systematic review and meta-analysis of chewing-gum therapy in the reduction of postoperative paralytic ileus following gastrointestinal surgery. World J Surg 33(12):2557–2566CrossRef
15.
Zurück zum Zitat De Castro SM, Van den Esschert JW, Van Heek NT, Dalhuisen S, Koelemay MJ, Busch OR, Gouma DJ (2008) A systematic review of the efficacy of gum chewing for the amelioration of postoperative ileus. Digest Surg 25(1):39–45CrossRef De Castro SM, Van den Esschert JW, Van Heek NT, Dalhuisen S, Koelemay MJ, Busch OR, Gouma DJ (2008) A systematic review of the efficacy of gum chewing for the amelioration of postoperative ileus. Digest Surg 25(1):39–45CrossRef
16.
Zurück zum Zitat Mei B, Wang W, Cui F, Wen Z, Shen M. Chewing gum for intestinal function recovery after colorectal cancer surgery: a systematic review and meta-analysis. Gastroenterol Res Pract. 2017;2017. Mei B, Wang W, Cui F, Wen Z, Shen M. Chewing gum for intestinal function recovery after colorectal cancer surgery: a systematic review and meta-analysis. Gastroenterol Res Pract. 2017;2017.
17.
Zurück zum Zitat Quah HM, Samad A, Neathey AJ, Hay DJ, Maw A (2006) Does gum chewing reduce postoperative ileus following open colectomy for left-sided colon and rectal cancer? A prospective randomized controlled trial. Colorectal Dis 8:64–70CrossRef Quah HM, Samad A, Neathey AJ, Hay DJ, Maw A (2006) Does gum chewing reduce postoperative ileus following open colectomy for left-sided colon and rectal cancer? A prospective randomized controlled trial. Colorectal Dis 8:64–70CrossRef
18.
Zurück zum Zitat Marwah S, Sham Singla PT (2012 Mar) Role of gum chewing on the duration of postoperative ileus following ileostomy closure done for typhoid ileal perforation: a prospective randomized trial. Saudi J Gastroenterol 18(2):111CrossRef Marwah S, Sham Singla PT (2012 Mar) Role of gum chewing on the duration of postoperative ileus following ileostomy closure done for typhoid ileal perforation: a prospective randomized trial. Saudi J Gastroenterol 18(2):111CrossRef
Metadaten
Titel
Role of Chewing Gum in Reducing Postoperative Ileus after Reversal of Ileostomy: A Randomized Controlled Trial
verfasst von
Samiullah Bhatti
Yusra Jahangir Malik
Shabbar Hussain Changazi
Usman Ali Rahman
Awais Amjad Malik
Usman Ismat Butt
Muhammad Umar
Muhammad Waris Farooka
Mahmood Ayyaz
Publikationsdatum
05.01.2021
Verlag
Springer International Publishing
Erschienen in
World Journal of Surgery / Ausgabe 4/2021
Print ISSN: 0364-2313
Elektronische ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-020-05897-1

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