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Does Chewing Gum Lead to Earlier Postoperative Gastrointestinal Recovery in Children? A Systematic Review and
Adrian Chi-Heng Fung1, Jaime Tsz-Wing Tsang1, Patrick Ho-Yu Chung1
1Department of Surgery, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong.
Insights
Chewing gum does not accelerate gastrointestinal recovery in children after surgery. This systematic review found no significant benefits for time to flatus, stool, oral intake, or hospital stay in pediatric patients chewing gum postoperatively.
Area of Science:
- Pediatric Surgery
- Gastrointestinal Motility
- Evidence-Based Medicine
Background:
- Postoperative ileus is common in children undergoing major surgeries.
- Adult studies suggest chewing gum may speed gastrointestinal recovery.
- Evidence in pediatric populations is limited.
Conclusions:
- Current evidence indicates gum chewing does not improve postoperative gastrointestinal recovery in children.
- Further well-designed trials are needed to confirm clinical benefits and impact on patient satisfaction.
Introduction:
Postoperative ileus is a common occurrence among children undergoing major operations, including gastrointestinal and spinal surgeries. Preliminary evidence in adults suggests that chewing gum plays a role in accelerating the return of postoperative gastrointestinal function. However, evidence is scarce in the paediatric population. The aim of this study was to investigate whether chewing gum has benefits for children.
Methods:
We searched PubMed, Medline, Embase, and Cochrane Trials databases for randomised controlled trials that compare gum chewing with standard care after elective surgery in children from 1st Jan 2005 to 31st July 2021. We assessed the identified trials for quality and performed a systematic review and meta-analysis in accordance with PRISMA and registered in PROSPERO (CRD42022358801). The main outcome measures examined were time to flatus and stool postoperatively, time to tolerate oral intake, and length of hospital stay, which were analysed using fixed effects models. We also examined clinical complication rates and postoperative pain control.
Results:
We included six eligible trials, with a total of 357 enrolled patients. The intervention was well tolerated without complications. There was no significant difference in time to flatus (-2.86 h; 95 % CI: -6.2 to 0.47 h, p = 0.09), time to stool (-6.39 h; 95 % CI: -13.9 to 1.2 h, p = 0.1), time to tolerate oral intake (-0.03 days; 95 % CI: -0.15 to 0.1 days, p = 0.68), and length of hospital stay (0.08 days; 95 % CI: -0.07 to 0.22 days, p = 0.29). Postoperative pain control (opioid consumption, pain score, nausea score) was similar in both groups (p > 0.05).
Conclusion:
Current evidence demonstrates that gum chewing is not associated with earlier postoperative gastrointestinal recovery in children. Future adequately powered and well-designed trials are necessary to evaluate any clinical benefit of chewing gum for children and whether it could result differences in healthcare satisfaction.
Level Of Evidence:
I.
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