Role of Chewing Gum in Reducing Postoperative Ileus after Reversal of Ileostomy: A Randomized Controlled Trial

Bhatti, Samiullah; Malik, Yusra Jahangir; Changazi, Shabbar Hussain; Rahman, Usman Ali; Malik, Awais Amjad; Butt, Usman Ismat; Umar, Muhammad; Farooka, Muhammad Waris; Ayyaz, Mahmood

doi:10.1007/s00268-020-05897-1

Cited by 14 publications

(13 citation statements)

References 30 publications

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“…It is clear that the most pronounced improvement occurred after the initial cohort was treated and hence the implication is that the institutional 'learning curve' for PTE surgery may be up to 500 procedures. This fits with later independent evaluations suggesting a technical learning curve of approximately 125 procedures for each individual surgeon in this program (20). With a better understanding of CTEPH and the availability of drug treatments and BPA, it may be that initial results in a contemporary era could be better than historical results described here.…”

Section: Discussionsupporting

confidence: 72%

Pulmonary thromboendarterectomy—the Royal Papworth experience

Jenkins¹,

Tsui²,

Taghavi³

et al. 2022

Ann Cardiothorac Surg

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and review activity and outcomes by era at a high-volume PTE center. During this period the understanding of chronic thromboembolic pulmonary hypertension (CTEPH) increased and drug treatments and balloon angioplasty were developed. We also review our contribution to the better understanding of this surgery and CTEPH. Methods: We retrospectively reviewed all patients undergoing PTE for CTEPH at our center between Jan 1997 and Sept 2019, dividing them into four equal cohorts. Pre-operative characteristics and postoperative outcomes are described by era. A MEDLINE search was performed and original scientific clinical publications from this unit were reviewed. Their contemporary relevance and influence to the evolution of the clinical service are discussed.Results: Over this 23-year period from the commencement of our program, 2116 consecutive PTE were performed. The mean patient age was 57.8 years (range 14−89). The first 25% of our PTE were performed over 12 years whilst the most recent 25% were performed in less than three years. Over time, the average pre-operative mean pulmonary artery pressure has not changed significantly. The 30-day mortality by era quartile has progressively fallen from 12.3% to 1.9% most recently (P<0.001). Overall, one year survival exceeded 90%. 17 publications influenced our practice development during this period.Conclusions: There was a consistent increase in activity and significant improvement in outcomes between the first and last quartiles of activity studied.

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Section: Discussionsupporting

confidence: 72%

Pulmonary thromboendarterectomy—the Royal Papworth experience

Jenkins¹,

Tsui²,

Taghavi³

et al. 2022

Ann Cardiothorac Surg

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“…However, in the subgroup analysis, there was no significant difference between the two groups only in preoperative chewing gum, but there was a significant difference in the preoperative and postoperative chewing gum group. Previous studies have also shown that chewing gum after operation can shorten the hospital stay (Bhatti et al, 2021; Pereira Gomes Morai et al, 2016; Yenigul et al, 2020), which also suggests that we may have a similar or stronger effect of chewing gum before and after operation, but there is no research to explore at present. In addition, this study found that chewing gum before operation had no significant effect on preoperative hunger, postoperative vomiting and abdominal distension, which may be caused by different factors such as the number of chewing gum, chewing time and the type of operation.…”

Section: Discussionmentioning

confidence: 90%

Efficacy and safety of preoperative chewing gum for undergoing elective surgery: A meta‐analysis of randomised controlled trials

Chen

Chang

Yuan

et al. 2023

Journal of Clinical Nursing

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Aims and Objectives:This meta-analysis aimed to investigate the safety and feasibility of preoperative chewing gum in adult patients undergoing elective surgery.Background: Postoperative chewing gum has been shown to be safe and effective for most surgeries, while the safety and efficacy of preoperative chewing gum are still controversial. Design:A meta-analysis of randomised controlled trials was performed.No Patient or Public Contribution: This was a meta-analysis involving no people or animals. Methods:The literature search was performed in 9 databases from inception to July 2022. Randomised controlled trials that compared the safety and efficacy of preoperative chewing gum and preoperative chewing no gum in adult patients undergoing elective surgery were included. The study was reported in compliance with PRISMA statement. Trial registration: PROSPERO CRD42022330223.Results: Fourteen trials involving 1433 adult patients who undergo elective surgery were pooled in this meta-analysis. The results showed that preoperative chewing gum group resulted in no significant difference in gastric pH (p = .13) and gastric fluid volume (p = .25) compared with non-gum-chewing group. In comparison with the non-gum-chewing group, the gum-chewing group was associated with shorter preoperative thirst score (p = .02), lower incidence of postoperative nausea (p = .0004), lower incidence of postoperative sore throat, lower incidence of postoperative hoarseness, lower postoperative pain score, shorter first postoperative anal exhaust time (p < .00001), shorter first postoperative defecation time (p < .00001) and shorter hospital days (p = .02). Conclusions:Preoperative chewing gum was associated with lower discomforts and complication rates, without increasing gastric pH and gastric fluid volume. This strategy may be an innovative, feasible and safe choice for elective surgery in adults.Relevance to Clinical Practice: This study's results could be used as an evidence for the implementation of preoperative chewing gum in perioperative care for adult patients undergoing elective surgery.

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“…Paraffin oil is rarely absorbable and non-digestible, colorless and tasteless mineral oil, preventing water absorption, lubricating the intestinal wall and feces, and softening the stool (19). Chewing gum can promote gastrointestinal peristalsis and digestive enzyme secretion (20).…”

Section: Postoperative Monitoring and Patient Educationmentioning

confidence: 99%

Case report: laparoscopic radical cystectomy on a patient with Behçet’s syndrome, our initial experience on perioperative safety

Xue¹,

Yang²,

Ji³

et al. 2022

Transl Androl Urol

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Behçet's syndrome (BS) is a rare systemic vasculitis that involves multiple systems and organs.Owing to the long-term prescription of immunosuppressive drugs, patients with BS are prone to urothelial tumors. However, surgical treatment in these cases could be dangerous because of the potential BS-related vasculitis, bleeding, and anastomotic necrosis. Literature reported that only five radical cystectomy cases had been performed on patients with BS, whereas the perioperative mortality was 40%. Moreover, perioperative managements on these cases were less discussed due to their multidisciplinary nature and rarity. We herein report a 54-year-old patient with a 13-year history of BS, diagnosed with sarcomatoid urothelial carcinoma and successfully underwent laparoscopic radical cystectomy with bilateral ureterocutaneostomy. No evidence of tumor residual or ureterocutaneostomic necrosis was reported in the subsequent three months of followup. In this case, the advantages of minimally invasive surgery in dealing with the parailiac lymph nodes were demonstrated. This article presented our thoughts, strategies, and experience on ensuring the patient's perioperative safety, as well as the selection of urinary diversion. We reviewed the literature in both English and Mandarin Chinese. Currently, two published articles describe the adoption of cystectomy in treating bladder cancer patients complicated with BS, whereas not any had shared the experience of using minimally invasive surgery. Hopefully, it could offer updated and enlightening significance to all related medical practitioners.

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Role of Chewing Gum in Reducing Postoperative Ileus after Reversal of Ileostomy: A Randomized Controlled Trial

Cited by 14 publications

References 30 publications

Pulmonary thromboendarterectomy—the Royal Papworth experience

Pulmonary thromboendarterectomy—the Royal Papworth experience

Efficacy and safety of preoperative chewing gum for undergoing elective surgery: A meta‐analysis of randomised controlled trials

Case report: laparoscopic radical cystectomy on a patient with Behçet’s syndrome, our initial experience on perioperative safety

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