1Department of Surgery, John Hunter Hospital, Newcastle, New South Wales, Australia 2University of Newcastle, Newcastle, New South Wales, Australia 3Department of Medicine, John Hunter Hospital, Newcastle, New South Wales, Australia.
Dis Colon Rectum. 2014 Jan;57(1):115-26. doi: 10.1097/DCR.0b013e3182a665be.
Sham feeding has been shown to hasten the return of GI function following colorectal surgery, before the advent of enhanced recovery after surgery protocols. Few data exist regarding the efficacy of sham feeding in the modern era, with rapid postoperative feeding.
We sought to perform a meta-analysis on the effect of sham feeding in colorectal surgery, with a separate analysis on trials that used rapid postoperative feeding.
Cochrane, MEDLINE, EMBASE, Scopus, and PubMed were searched by using the terms gum OR sham feeding OR chew AND (colorect OR resect).
All studies were randomized controlled trials (in any language) performed on adults, comparing standard care with gum chewing following colorectal resection. From 439 citations, 10 articles were included.
The intervention was sham feeding by means of gum chewing.
The outcome measures were time to return of flatus, time to first bowel movement, complication rates, length of hospital stay, readmission rates, and reoperation rates.
Ten randomized controlled trials (n = 612) were included. Sham feeding resulted in a reduction in time to flatus of 31 minutes (p = 0.003) and time to first bowel movement of 30 minutes (p = 0.05). Sham feeding also resulted in a reduction in length of stay by 0.5 days (p = 0.007), and a reduction in complication rates (relative risk = 0.687, p = 0.017), although this appeared to be associated with publication bias. Analysis of trials that used rapid postoperative feeding (n = 282) revealed no difference in postoperative GI function.
This review was limited by the heterogeneity of postoperative feeding regimes, in addition to limited reporting by trials of postoperative morbidity.
Sham feeding following colorectal surgery is safe, results in small improvements in GI recovery, and is associated with a reduction in the length of hospital stay. It confers no advantage if patients are placed on a rapid postoperative feeding regime.
在加速康复外科（ERAS）方案出现之前，假饲已被证明可以加速结直肠手术后胃肠道功能的恢复。关于在快速术后喂养的现代时代假饲的疗效，数据很少。
我们旨在对结直肠手术中假饲的效果进行荟萃分析，并对使用快速术后喂养的试验进行单独分析。
使用术语“gum OR sham feeding OR chew AND (colorect OR resect)”，检索 Cochrane、MEDLINE、EMBASE、Scopus 和 PubMed 数据库。
所有研究均为比较结直肠切除术后标准护理与咀嚼口香糖的随机对照试验（任何语言），纳入对象为成年人。从 439 条引文中共纳入 10 篇文章。
干预措施为通过咀嚼口香糖进行假饲。
观察指标为肛门排气时间、首次排便时间、并发症发生率、住院时间、再入院率和再次手术率。
共纳入 10 项随机对照试验（n = 612）。假饲可使肛门排气时间减少 31 分钟（p = 0.003）和首次排便时间减少 30 分钟（p = 0.05）。假饲还可使住院时间缩短 0.5 天（p = 0.007），并发症发生率降低（相对风险 = 0.687，p = 0.017），尽管这似乎与发表偏倚有关。对使用快速术后喂养的试验（n = 282）进行分析，结果显示术后胃肠道功能无差异。
本综述受到术后喂养方案异质性的限制，此外试验对术后发病率的报告也有限。
结直肠手术后假饲是安全的，可使胃肠道恢复略有改善，并可降低住院时间。如果患者采用快速术后喂养方案，则假饲没有优势。
