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Chewing Gum After Radical Cystectomy With Urinary Diversion for Recovery of Intestinal Function: A Systematic Review
Craig S Atkins1, Tito D Tubog1, Scott K Schaffer1
1Texas Wesleyan University, Fort Worth, TX.
Purpose:
To evaluate the efficacy of chewing in the recovery of intestinal function after radical cystectomy.
Design:
Systematic review and meta-analysis.
Methods:
Following the PRISMA statement, PubMed, CINAHL, Google Scholar, Cochrane Review Database, EMBASE, Scopus, and grey literature were searched for evidence.
Findings:
The analysis included 2 trials with 100 patients. Compared to placebo, chewing gum resulted in faster recovery of bowel function (mean difference [MD], -16.00; 95% confidence interval [CI], -18.67 to -13.32; P < .00001). In addition, chewing gum decreased the time to flatus (MD, -14.81; 95% CI, -22.14 to -7.47; P < .0001), but did not reduced the length of stay (MD, 0.97; 95% CI, -1.23 to 3.18; P = .39) and the incidence of postoperative ileus (risk ratio, 0.67; 95% CI, 0.20-2.23; P = .51). The quality of evidence is low due to imprecision and suspected publication bias.
Conclusions:
Chewing gum appears to be an inexpensive intervention to improve the return of bowel function in patients undergoing radical cystectomy.
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