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Does gum chewing reduce postoperative ileus following open colectomy for left-sided colon and rectal cancer? – a prospective randomized controlled trial

Authors


Mr Andrew Maw, Consultant Surgeon, Department of Colorectal and General Surgery, Glan Clwyd Hospital, Rhyl, Denbighshire LL18 5UJ, UK.
E-mail: Andrew.Maw@cd-tr.wales.nhs.uk

Abstract

Objective  Postoperative ileus is common after colorectal resection and can prolong hospital stay. Gum chewing, a type of sham feeding, may to stimulate gut motility via cephalic-vagal stimulation, and thereby reduce the length of ileus. This study aimed to determine whether gum chewing in the immediate postoperative period facilitated recovery from ileus following resection for left-sided colorectal cancer.

Methods  In a prospective randomized control trial, 38 patients undergoing open surgery for left-sided colorectal cancer were allocated to standard postoperative care (control group, n = 19) or to standard postoperative care plus the immediate use of chewing gum (treatment group, n = 19).

Result  Control patients passed flatus by mean of 2.7 days (SD 1.0) and faeces by 3.9 days (SD 1.5); for the treatment group, this was 2.4 days (SD 1.0) and 3.2 days (SD 1.5) respectively, (NS, P = 0.56 and P = 0.38). Length of hospital stay was 11.1 days (SD 7.3) in control group and 9.4 days (SD 2.5) in the treatment group (NS, P = 0.75).

Conclusion  The addition of gum chewing to a standardized postoperative regimen did not reduce the period of postoperative ileus or shorten length of stay following open surgery for left-sided colorectal cancer.

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