Usefulness of Gum Chewing to Decrease Postoperative Ileus in Colorectal Surgery with Primary Anastomosis: A...

Area of Science:

• Colorectal Surgery
• Gastrointestinal Motility
• Postoperative Care

Background:

• Postoperative ileus (POI) significantly increases patient morbidity, hospital stay duration, and healthcare costs.
• Effective strategies to mitigate POI are crucial for improving surgical outcomes and patient recovery.
• Current management of POI often involves supportive care, with limited interventions proven to accelerate recovery.

Purpose of the Study:

• To evaluate the efficacy and safety of chewing gum as an intervention to reduce postoperative ileus in patients undergoing colorectal surgery.
• To compare the incidence of postoperative ileus, vomiting, and time to recovery between patients who chewed gum and those receiving standard postoperative care.

Main Methods:

• A randomized controlled trial was conducted with 64 patients undergoing elective colorectal surgery with primary anastomosis.
• Patients were randomized into two groups: gum chewing (n=32) and standard postoperative recovery (n=32).
• Outcomes assessed included the incidence of postoperative ileus, vomiting, flatus passage, oral feeding time, and length of hospital stay.

Main Results:

• The gum-chewing group showed a significantly lower incidence of postoperative ileus (6% vs. 21.8%, p=0.006) and vomiting (6.25% vs. 25.0%, p=0.03).
• Patients in the gum-chewing group experienced a higher rate of flatus passage within 48 hours (94% vs. 63%, p=0.002).
• While trends suggested earlier oral feeding and shorter hospital stays in the gum group, these did not reach statistical significance (p>0.05).

Conclusions:

• Chewing gum use following colorectal surgery is associated with reduced rates of postoperative ileus and vomiting.
• The intervention promotes earlier gastrointestinal function recovery, evidenced by increased flatus passage.
• Given its low cost, safety profile, and demonstrated benefits, chewing gum is a viable and recommended adjunct for enhancing postoperative recovery in elective colorectal surgery.