Meta-analysis comparing chewing gum versus standard postoperative care after colorectal resection
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Guo-Min Song1,*, Yong-Hong Deng2,*, Ying-Hui Jin2,3,*, Jian-Guo Zhou4, Xu Tian5
1Department of Nursing, Tianjin Hospital, Tianjin 300211, China
2School of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China
3Evidence-Based Nursing Center, Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China
4Department of Oncology, Affiliated Hospital of Zunyi Medical University, Zunyi 563000, China
5Department of Nursing, Chongqing Cancer Institute, Chongqing 400020, China
*These authors have contributed equally to this work
Xu Tian, email: [email protected]
Keywords: chewing gum, postoperative ileus, colorectal surgery, meta-analysis, trial sequential analysis
Received: July 04, 2016 Accepted: August 18, 2016 Published: August 31, 2016
Background: Previous incomplete studies investigating the potential of chewing gum (CG) in patients undergoing colorectal resection did not obtain definitive conclusions. This updated meta-analysis was therefore conducted to evaluate the effect and safety of CG versus standard postoperative care protocols (SPCPs) after colorectal surgery.
Results: Total 26 RCTs enrolling 2214 patients were included in this study. The CG can be well-tolerated by all patients. Compared with SPCPs, CG was associated with shorter time to first flatus (weighted mean difference (WMD) -12.14 (95 per cent c.i. -15.71 to -8.56) hours; P < 0.001), bowl movement (WMD -17.32 (-23.41 to -11.22) hours; P < 0.001), bowel sounds (WMD -6.02 (-7.42 to -4.63) hours; P < 0.001), and length of hospital stay (WMD -0.95 (-1.55 to -0.35) days; P < 0.001), a lower risk of postoperative ileus (risk ratio (RR) 0.61 (0.44 to 0.83); P = 0.002), net beneficial and quality of life. There were no significant differences between the two groups in overall complications, nausea, vomiting, bloating, wound infection, bleeding, dehiscence, readmission, reoperation, mortality.
Materials and Methods: The potentially eligible randomized controlled trials (RCTs) that compared CG with SPCPs for colorectal resection were searched in PubMed, Embase, Cochrane library, China National Knowledge Infrastructure (CNKI), and Chinese Wanfang databases through May 2016. The trial sequential analysis was adopted to examine whether a firm conclusion for specific outcome can be drawn.
Conclusions: CG is benefit for enhancing return of gastrointestinal function after colorectal resection, and may be associated with lower risk of postoperative ileus.
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