HUANG Liping , WEN Shiqi , LI Jiafei , LI Ka
  • Medicine and Engineering Interdisciplinary Research Laboratory of Nursing & Materials, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu 610041, P. R. China;
LI Ka, Email: lika127@163.com
chewing gum; colon cancer; rectal cancer; colorectal cancer; gastrointestinal function; meta-analysis
10.7507/1007-9424.202407025
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Objective To assess the effect of chewing gum on the recovery of gastrointestinal function in postoperative colorectal cancer patients. Methods A comprehensive search for relevant randomised controlled trials (RCTs) was conducted in domestic and international databases such as PubMed, The Cochrane Library, Web of Science, Chinese Science and Technology Journal Full-text Database, Chinese Periodicals Full-text Database, Wanfang data, and other databases, with a timeframe up to September 2023. The literature was screened according to the inclusion and exclusion criteria and literature quality evaluation and data extraction were performed. The continuous variables were described using mean difference (95% confidence interval) and the binary variables were described using odds ratio (95% confidence interval). Test level was α=0.05. Results A total of 28 RCTs covering 2 523 postoperative colorectal cancer patients were included. The meta-analysis results showed that the postoperative chewing gum significantly shortened the time to the first flatus [–11.99 (–14.45, –9.53)], the first defecation [–18.79 (–23.58, –14.00)], the first bowel sounds [–6.35 (–6.64, –6.06)] or the first starvation [–5.20 (–10.11, –0.28)], and the length of postoperative hospital stay [–1.35 (–1.99, –0.70)], as well as increased the serum gastrin level [23.70 (14.88, 32.53)]. Furthermore, it also reduced the incidence of postoperative complications, such as nausea [0.66 (0.48, 0.91)], abdominal distension [0.48 (0.35, 0.67)], and intestinal obstruction [0.34 (0.20, 0.59)]. However, there was a non-significant effect on vomiting [0.81 (0.60, 1.09)] or time to the first oral intake [–0.67 (–1.99, 0.65)]. Conclusions From the results of this meta-analysis, postoperative gum chewing aids to the recovery of gastrointestinal function and reduces the risk of postoperative complications in colorectal cancer patients. Although further studies are needed to verify the long-term effects and the feasibility of clinical application, the results of this study provide an important empirical support for the use of gum chewing in the management of postoperative gastrointestinal function.