Document Detail


Is gum chewing useful for ileus after elective colorectal surgery? A systematic review and meta-analysis of randomized clinical trials.
MedLine Citation:
PMID:  19050983     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The evaluation of the usefulness of gum chewing for postoperative ileus has given inconclusive results. We evaluated the efficacy of gum chewing in the treatment of ileus after elective colorectal surgery. MATERIALS AND METHODS: We performed a meta-analysis of randomized clinical trials comparing the effect of gum chewing+standard treatment vs. standard treatment on ileus after colorectal surgery. MEDLINE, EMBASE, the Cochrane Controlled Trial Register, and the Cochrane Database of Systematic Reviews were searched until August 2008. Primary outcomes were time to first flatus, time to first passage of feces, and length of hospital stay. The mean difference (MD) in hours was calculated with the random effects model to assess the effect of gum chewing on the outcomes. RESULTS: Six trials including 244 patients were analyzed. Time to first flatus was significantly reduced with gum chewing+standard treatment compared to standard treatment alone (MD -14 h, 95% confidence interval [95%CI] -23.5 to -4.6). Time to first passage of feces was significantly reduced (MD -25 h, 95%CI -42.3 to -7.7), but the length of hospital stay was only marginally reduced (MD -26.2 h, 95%CI -57.5 to 5.2) with gum chewing. CONCLUSION: In patients with ileus after colonic surgery, gum chewing in addition to standard treatment significantly reduces the time to first flatus and the time to first passage of feces when compared to standard treatment alone. There is also a trend to reduce the length of hospital stay. Gum chewing should be added to the standard treatment of these patients.
Authors:
Wenceslao Vásquez; Adrián V Hernández; Jose Luis Garcia-Sabrido
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Publication Detail:
Type:  Journal Article; Meta-Analysis; Review     Date:  2008-12-03
Journal Detail:
Title:  Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract     Volume:  13     ISSN:  1873-4626     ISO Abbreviation:  J. Gastrointest. Surg.     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-05-01     Completed Date:  2009-09-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9706084     Medline TA:  J Gastrointest Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  649-56     Citation Subset:  IM    
Affiliation:
Department of Surgery, Hospital Universitario Gregorio Marañón, Dr. Esquerdo 46, 28007, Madrid, Spain. tumi100@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Chewing Gum*
Defecation
Flatulence
Ileus / prevention & control,  therapy*
Length of Stay
Postoperative Complications / therapy*
Randomized Controlled Trials as Topic
Surgical Procedures, Elective
Chemical
Reg. No./Substance:
0/Chewing Gum

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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