Department of Urology, Korea University School of Medicine, Seoul, Korea.
Urology. 2011 Apr;77(4):884-90. doi: 10.1016/j.urology.2010.06.042. Epub 2010 Oct 15.
To determine whether chewing gum during the postoperative period facilitates the recovery of bowel function and has different efficacy according to operative method used in patients with radical cystectomy.
From July 2007 to September 2009, we randomized open radical cystectomy (ORC) patients into Group AI (ORC without gum chewing) and Group AII (ORC with gum chewing). Robot-assisted radical cystectomy (RARC) patients were randomized into Group BI (RARC without gum chewing) and Group BII (RARC with gum chewing).
A total of 32 ORC (17 Group AI and 15 Group AII) and 28 RARC (13 Group BI and 15 Group BII) patients were completed. The patient's perioperative data between the control (AI + BI) and chewing gum (AII + BII) group showed no differences. The median time to flatus and to bowel movement were significantly reduced in chewing gum group compared with the control patients: 57.1 vs. 69.5 hours 76.7 vs. 93.3 hours. In the ORC patients, decrease in time to flatus and bowel movement were observed in gum chewing (AII) group than control (AI) group: 64.3 vs. 80.3 hours 83.8 vs. 104.2 hours. In RARC patients, decrease in time to flatus and bowel movement were found in gum chewing (BII) group than control (BI) group: 48.8 vs. 60.3 hours 69.1 vs. 84.6 hours. No adverse effects were observed with chewing gum.
Chewing gum had stimulatory effects on bowel motility after cystectomy and urinary diversion. Chewing gum was safe and could be used for postoperative ileus regardless of the operative method (ORC or RARC).
确定在根治性膀胱切除术后咀嚼口香糖是否有助于恢复肠道功能，并根据手术方法的不同而产生不同的疗效。
2007 年 7 月至 2009 年 9 月，我们将接受开放式根治性膀胱切除术（ORC）的患者随机分为 AI 组（无口香糖咀嚼的 ORC）和 AII 组（有口香糖咀嚼的 ORC）。机器人辅助根治性膀胱切除术（RARC）患者随机分为 BI 组（无口香糖咀嚼的 RARC）和 BII 组（有口香糖咀嚼的 RARC）。
共有 32 例 ORC（17 例 AI 组和 15 例 AII 组）和 28 例 RARC（13 例 BI 组和 15 例 BII 组）患者完成了手术。对照组（AI+BI）和咀嚼口香糖组（AII+BII）患者的围手术期数据无差异。咀嚼口香糖组患者肛门排气和排便时间中位数明显短于对照组：57.1 小时 vs. 69.5 小时；76.7 小时 vs. 93.3 小时。在 ORC 患者中，口香糖咀嚼组（AII）的肛门排气和排便时间较对照组（AI）明显缩短：64.3 小时 vs. 80.3 小时；83.8 小时 vs. 104.2 小时。在 RARC 患者中，口香糖咀嚼组（BII）的肛门排气和排便时间较对照组（BI）明显缩短：48.8 小时 vs. 60.3 小时；69.1 小时 vs. 84.6 小时。咀嚼口香糖无不良反应。
咀嚼口香糖对膀胱切除术后肠道动力有刺激作用，并能促进尿路分流。无论手术方法（ORC 或 RARC）如何，咀嚼口香糖都是安全的，可用于术后肠梗阻。
