From the Division of Colorectal Surgery, Cedars Sinai Medical Center, Los Angeles, California, USA.
Dis Colon Rectum. 2013 Mar;56(3):328-35. doi: 10.1097/DCR.0b013e31827e4971.
A number of small prospective studies with conflicting results have evaluated the effect of sugar-free chewing gum on postoperative GI recovery in patients initially maintained nil per os after major colorectal surgery.
We sought to evaluate the effect of sugared chewing gum in combination with early enteral feeding on recovery of GI function after major colorectal surgery to ascertain any additive effects of this combination.
This was a randomized prospective study.
This study was conducted at a single-institution tertiary referral center.
Patients undergoing major colorectal surgery were included.
Patients were randomly assigned to sugared chewing gum (Gum) (instructed to chew 3 times daily; 45 minutes each time for 7 days postoperatively) or No Gum after major colorectal surgery.
The primary outcome measured was time to tolerating low residue diet without emesis for 24 hours. The secondary outcomes measured were time to flatus, time to bowel movement, postoperative hospital stay, postoperative pain, nausea, and appetite.
One hundred fourteen patients (60 No Gum; 54 Gum) were included in our analysis after randomization. There was no significant difference in time to tolerating a low-residue diet, time to flatus, time to bowel movement, length of postoperative hospital stay, postoperative complications, postoperative pain, nausea, or appetite between patients assigned to Gum or No Gum. There was an increased incidence of bloating, indigestion, and eructation in the Gum group (13%) in comparison with the No Gum group (2%) (p = 0.03).
Study subjects and investigators were not blinded. Multiple types of operations may cause intergroup variability.
There does not appear to be any benefit to sugared chewing gum in comparison with no gum in patients undergoing major colorectal surgery managed with early feeding in the postoperative period. There may be increased incidence of bloating, indigestion, and eructation, possibly related to swallowed air during gum chewing.
一些小型前瞻性研究结果相互矛盾，评估了无糖口香糖对接受大肠手术后初始禁食患者胃肠道恢复的影响。
我们旨在评估含糖口香糖与早期肠内喂养相结合对大肠手术后胃肠道功能恢复的影响，以确定这种组合的任何附加效果。
这是一项随机前瞻性研究。
这项研究在一家单一机构的三级转诊中心进行。
接受大肠手术的患者被纳入研究。
患者被随机分配到含糖口香糖（Gum）组（指导患者术后每天咀嚼 3 次；每次 45 分钟，共 7 天）或非 Gum 组。
主要观察指标为耐受低残留饮食且无呕吐 24 小时的时间。次要观察指标为排气时间、排便时间、术后住院时间、术后疼痛、恶心和食欲。
114 例患者（60 例非 Gum 组；54 例 Gum 组）在随机分组后纳入我们的分析。在耐受低残留饮食、排气、排便时间、术后住院时间、术后并发症、术后疼痛、恶心或食欲方面，Gum 组和非 Gum 组之间没有显著差异。Gum 组（13%）比非 Gum 组（2%）腹胀、消化不良和呃逆的发生率增加（p = 0.03）。
研究对象和研究者没有设盲。多种类型的手术可能导致组间的变异性。
与非 Gum 组相比，在接受早期喂养的大肠手术后患者中，无糖口香糖并没有任何益处。口香糖咀嚼时可能会吞下更多空气，导致腹胀、消化不良和呃逆的发生率增加。
