Effect of Chewing Gun on the Promotion of Intestinal Function Recovery after Colorectal Cancer Surgery: A Meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

 YANGXue-mei ¹ , ZHANGZheng-xin ¹ , TANXiao-yi ² , YANGAi-ling ¹ , TIANJin-hui ³ , ZHANGQing-xia ⁴

1. The Second Hospital of Lanzhou University, Lanzhou 730030, China;
2. The Second Clinical Medical College, Lanzhou University, Lanzhou 730030, China;
3. Evidence-Based Medicine Center, School of Basic Medical Science, Lanzhou University, Lanzhou 730000, China;
4. The Maternity and Children's Hospital of Gansu Province, Lanzhou 730050, China;

Corresponding author：

Keywords：

Colorectal cancer; Colon cancer; Rectal cancer; Chewing gun; Systematic review; Meta-analysis

DOI：

10.7507/1672-2531.20150091

Video：

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Objective To systematically review the effects of chewing gun on the promotion of intestinal function recovery after colorectal cancer surgery. Methods We searched PubMed, The Cochrane Library, CBM and CNKI databases from their inception to December 2014, to collect randomized controlled trials (RCTs) assessing chewing gun in patients after colorectal cancer surgery. References of included studies were also retrieved. Two reviewers independently screened studies according to inclusion and exclusion criteria, extracted data, and assessed the methodological quality of included studies. Then meta-analysis was performed using RevMan 5.2 software. Results Nine RCTs involved 686 patients were included. The results of meta-analysis indicated that, compared with the control group, chewing gun could significantly reduce the time to first passage of flatus (MD=-17.33, 95%CI -23.96 to -10.70, P<0.000 01), the time to the first defecation (MD=-22.25, 95%CI -36.45 to -8.05, P=0.002) and postoperative hospital stay (MD=-1.37, 95%CI -2.25 to -0.49, P=0.002) after colorectal cancer surgery, and could also reduce the intestinal obstruction caused by intestinal paralysis (OR=0.33, 95%CI 0.14 to 0.77, P=0.01). However, no significant difference in the incidence of nausea and vomiting was found. Conclusion Early chewing gum can promote the recovery of gastrointestinal function in patients after colorectal cancer operation.

Citation： YANGXue-mei, ZHANGZheng-xin, TANXiao-yi, YANGAi-ling, TIANJin-hui, ZHANGQing-xia. Effect of Chewing Gun on the Promotion of Intestinal Function Recovery after Colorectal Cancer Surgery: A Meta-analysis. Chinese Journal of Evidence-Based Medicine, 2015, 15(5): 542-549. doi: 10.7507/1672-2531.20150091 Copy

1.	汪建平. 重视结直肠癌流行病学研究. 中国实用外科杂志, 2013, 33(8):622-623.
2.	结直肠癌治疗新方法. 中国医药导刊, 2009,02. Available at:https://vpnt.lzu.edu.cn/prx/000/http/202.201.7.11/kcms/detail/detail.aspx?recid=&FileName=DKYY200902036&DbName=CJFD0910&DbCode=CJFQ&uid=akhtckZyZXYySnl5aHJHMFFIb3hsb1JkcFpHYldFT1Jnazh3bkpEY3g3RkQxN2po.
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4.	Vásquez W, Hernández AV, Garcia-Sabrido JL. Is Gum Chewing Useful for Ileus after Elective Colorectal Surgery? A Systematic Review and Meta-analysis of Randomized Clinical Trials. J Gastrointest Surg, 2009, 13(4):649-656.
5.	Parnaby CN, MacDonald AJ, Jenkins JT. Sham Feed or Sham? A meta-analysis of randomized clinical trials assessing the effect of gum chewing on gut function after elective colorectal surgery. Int J Colorectal Dis, 2009, 24(5):585-592.
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11.	Zaghiyan K, Felder S, Ovsepyan G, et al. A Prospective Randomized Controlled Trial of Sugared Chewing Gum on Gastrointestinal Recovery after Major Colorectal Surgery in Patients Managed with Early Enteral Feeding. Dis Colon Rectum, 2013, 56(3):328-335.
12.	Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.0 Available at:www.cochranehandbook.org.
13.	Asao T, Kuwano H, Nakamura J, et al. Gum chewing enhances early recovery from postoperative ileus after laparoscopic colectomy. Am Coll Surg, 2002, 195(1):30-32.
14.	Hirayama I, Suzuki M, Ide M, et al. Gumchewing stimulates bowel motility after surgery for colorectal cancer. Hepato-gastroenterology, 2006, 53(68):206-208.
15.	Quah HM, Samad A, Neathey AJ, et al. Does gum chewing reduce postoperative ileus following open colectomy for left-sided colon and rectal cancer?-a prospective randomized controlled trial. Colorectal Disease, 2006, 8(1):64-70.
16.	曹瑞金, 谌永毅, 陈慧, 等. 大肠癌患者术后咀嚼口香糖对肠道功能的影响. 当代护士(学术版), 2008, (11):45-46.
17.	凡庆东, 耿协强, 陈辉, 等. 咀嚼口香糖对结直肠癌根治术患者术后肠动力恢复的影响. 西南国防医药, 2009, 19(12):1240-1241.
18.	李燕君. 术后早期咀嚼口香糖对结肠癌患者胃肠功能的影响. 中外健康文摘, 2012, (41):69-70.
19.	田敏. 咀嚼口香糖对直肠癌患者手术后胃肠功能恢复的作用. 现代临床护理, 2013, 12(2):45-47.
20.	王少渊, 侯英奎, 董世平, 等. 直肠癌术后咀嚼口香糖促进胃肠康复的随机对照研究. 四川医学, 2011, 32(12):1956-1958.
21.	钟紫凤, 叶锋, 林建江. 咀嚼运动促进直肠癌根治术后胃肠动力的研究. 中华胃肠外科杂志, 2009, 12(6):632-633.
22.	Mattei P, Rombeau JL. Review of the pathophysiology and management of postoperative ileus. World J Surg, 2006, 30(8):1382-1391.
23.	Miedema BW, Johnson JO. Methods for decreasing post operative gut dismotility. Lancet Oncol, 2003, 4(6):365-372.
24.	Ward CW. Fast track program to prevent postoperative ileus. Med Surg Nurs, 2012, 21(4):214-220.
25.	de Castro SM, van den Esschert JW, van Heek NT. A systematic review of the efficacy of gum chewing for the amelioration of postoperative ileus. Dig Surg, 2008, 25(1):39-45.
26.	Tandeter H. Hypothesis:hexitols in chewing gun may play a role in reducing postoperative ileus. Med hypotheses, 2009, 72(1):39-40.

1. 汪建平. 重视结直肠癌流行病学研究. 中国实用外科杂志, 2013, 33(8):622-623.
2. 结直肠癌治疗新方法. 中国医药导刊, 2009,02. Available at:https://vpnt.lzu.edu.cn/prx/000/http/202.201.7.11/kcms/detail/detail.aspx?recid=&FileName=DKYY200902036&DbName=CJFD0910&DbCode=CJFQ&uid=akhtckZyZXYySnl5aHJHMFFIb3hsb1JkcFpHYldFT1Jnazh3bkpEY3g3RkQxN2po.
3. 马向涛. 接诊医院与医师手术量差异对结直肠癌患者并发症与预后的影响. 医学与哲学, 2013, 34(6B):86.
4. Vásquez W, Hernández AV, Garcia-Sabrido JL. Is Gum Chewing Useful for Ileus after Elective Colorectal Surgery? A Systematic Review and Meta-analysis of Randomized Clinical Trials. J Gastrointest Surg, 2009, 13(4):649-656.
5. Parnaby CN, MacDonald AJ, Jenkins JT. Sham Feed or Sham? A meta-analysis of randomized clinical trials assessing the effect of gum chewing on gut function after elective colorectal surgery. Int J Colorectal Dis, 2009, 24(5):585-592.
6. de Castro SM, vanden Esschert JW, van Heek NT, et al. A systematic review of the efficacy of gum chewing for the amelioration of postoperative ileus. Dig Surg, 2008, 25(1):39-45.
7. Purkayastha S, Tilney HS, Darzi AW, et al. Meta-analysis of Randomized Studies Evaluating Chewing Gum to Enhance Postoperative Recovery Following Colectomy. Arch Surg, 2008, 143(8):788-793.
8. 王枭杰, 池畔. 咀嚼口香糖促进结直肠疾病术后肠道功能恢复的Meta分析. 中华胃肠外科杂志, 2013, 16(11):1078-1083.
9. Lim P, Morris OJ, Nolan G, et al. Sham feeding with chewing gum after elective colorectal resectional surgery:a randomized clinical trial. Ann surg, 2013, 257(6):1016-1024.
10. Crainic C, Erickson K, Gardner J, et al. Comparison of MethodseTo Facilitate Postoperative Bowel Function. Medsurg Nurs, 2009, 18(4):235-238.
11. Zaghiyan K, Felder S, Ovsepyan G, et al. A Prospective Randomized Controlled Trial of Sugared Chewing Gum on Gastrointestinal Recovery after Major Colorectal Surgery in Patients Managed with Early Enteral Feeding. Dis Colon Rectum, 2013, 56(3):328-335.
12. Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.0 Available at:www.cochranehandbook.org.
13. Asao T, Kuwano H, Nakamura J, et al. Gum chewing enhances early recovery from postoperative ileus after laparoscopic colectomy. Am Coll Surg, 2002, 195(1):30-32.
14. Hirayama I, Suzuki M, Ide M, et al. Gumchewing stimulates bowel motility after surgery for colorectal cancer. Hepato-gastroenterology, 2006, 53(68):206-208.
15. Quah HM, Samad A, Neathey AJ, et al. Does gum chewing reduce postoperative ileus following open colectomy for left-sided colon and rectal cancer?-a prospective randomized controlled trial. Colorectal Disease, 2006, 8(1):64-70.
16. 曹瑞金, 谌永毅, 陈慧, 等. 大肠癌患者术后咀嚼口香糖对肠道功能的影响. 当代护士(学术版), 2008, (11):45-46.
17. 凡庆东, 耿协强, 陈辉, 等. 咀嚼口香糖对结直肠癌根治术患者术后肠动力恢复的影响. 西南国防医药, 2009, 19(12):1240-1241.
18. 李燕君. 术后早期咀嚼口香糖对结肠癌患者胃肠功能的影响. 中外健康文摘, 2012, (41):69-70.
19. 田敏. 咀嚼口香糖对直肠癌患者手术后胃肠功能恢复的作用. 现代临床护理, 2013, 12(2):45-47.
20. 王少渊, 侯英奎, 董世平, 等. 直肠癌术后咀嚼口香糖促进胃肠康复的随机对照研究. 四川医学, 2011, 32(12):1956-1958.
21. 钟紫凤, 叶锋, 林建江. 咀嚼运动促进直肠癌根治术后胃肠动力的研究. 中华胃肠外科杂志, 2009, 12(6):632-633.
22. Mattei P, Rombeau JL. Review of the pathophysiology and management of postoperative ileus. World J Surg, 2006, 30(8):1382-1391.
23. Miedema BW, Johnson JO. Methods for decreasing post operative gut dismotility. Lancet Oncol, 2003, 4(6):365-372.
24. Ward CW. Fast track program to prevent postoperative ileus. Med Surg Nurs, 2012, 21(4):214-220.
25. de Castro SM, van den Esschert JW, van Heek NT. A systematic review of the efficacy of gum chewing for the amelioration of postoperative ileus. Dig Surg, 2008, 25(1):39-45.
26. Tandeter H. Hypothesis:hexitols in chewing gun may play a role in reducing postoperative ileus. Med hypotheses, 2009, 72(1):39-40.

Chinese Journal of Evidence-Based Medicine

Effect of Chewing Gun on the Promotion of Intestinal Function Recovery after Colorectal Cancer Surgery: A Meta-analysis

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