Sham Feeding With Chewing Gum After Elective Colorectal Resectional Surgery

Abstract

Sham feeding with gum, after open and laparoscopic colorectal resectional surgery is safe, but does not hasten the return of gastrointestinal function in patients who receive accelerated postoperative feeding. (ACTRN12607000538448).

Comparison of efficacy of simo decoction and acupuncture or chewing gum alone on postoperative ileus in colorectal cancer resection: a randomized trial

“…Only two of 565 patients in the entire population (0.35%) died within 90 days after surgery, and none of the deaths was attributed to the intervention (chewing gum). These findings are consistent with similar reports showing the safety of SMD, acupuncture and chewing gum after surgery125212223. We conclude that SMD, acupuncture, and chewing gum do not significantly affect risk of incidence or type of complications.…”

“…Whatever the explanation, our results suggest, for the first time, that chewing gum may offer clinical benefit only to a subset of patients undergoing surgery. This possibility, which should be verified and extended in future work, is consistent with studies showing that, with the implementation of fast-track surgery in recent decades, chewing gum can be neither clearly recommended nor prohibited as a gastrointestinal stimulant212223.…”

“…First, the study population of 590 patients, recruited over two years, is larger than in similar RCTs in the literature. Second, the study population included only patients with colorectal cancer with no history of abdominal surgery, making it more homogeneous than the populations in previous trials that included patients with various types of colorectal disease22223 or with a history of abdominal surgery2. Third, in part because of our large sample, we were able to perform subgroup analysis based on open or laparoscopic resection.…”

“…A second limitation is lack of blinding for patients and doctors, which was judged impractical because of the nature of the interventions. This limitation is shared with similar trials in the literature212223, and we attempted to compensate for potential bias by blinding the nursing staff to assess primary outcomes and statistician to patient allocation throughout data analysis. A third limitation is that some patients within each arm received opioid analgesia, which may have confounded our analysis5.…”

“…Chewing gum has emerged as a popular method for reducing the incidence of POI, but its efficacy is controversial. While some systematic reviews and meta-analyses indicate that it can lead to significantly better postoperative bowel function410111213141516 and several official guidelines recommend it for preventing POI17181920, three recent RCTs failed to demonstrate an effect of chewing gum on the recovery of bowel function after colorectal resection212223.…”