Muhumuza Joshua, Molen Selamo F, Bassara Godefroy N, Waziri Musa A, Kithinji Stephen M, Sonye Kiyaka M, Leocadie Mugisho M, Kagenderezo ByaMungu P, Tshimanga Esperant T, Faustin Tatana M, Lule Herman
Department of Surgery, Faculty of clinical medicine and dentistry, Kampala International University Western Campus, P. O. Box 70, Ishaka Bushenyi, Uganda.
Department of Clinical Medicine, Division of Clinical Neurosciences, University of Turku and Turku University Hospital, Turku, FI-20014, Finland.
BMC Gastroenterol. 2025 May 23;25(1):402. doi: 10.1186/s12876-025-04016-5.
Prolonged postoperative ileus is linked to a higher risk of additional complications, longer hospital stays, and higher healthcare expenses. There are few randomized controlled trials on the impact of chewing gum on the duration of ileus in patients undergoing emergency surgery, notably those with peritonitis. Compelling evidence from studies on elective procedures demonstrates that chewing gum can lessen the duration of ileus. This trial aimed to examine the effect of chewing gum on the length of the postoperative ileus which develop after laparotomy for gastroduodenal perforations.
Multicentre randomized controlled trial. Fifty-two patients were randomly assigned to two treatment groups. Group A received routine care with chewing gum, while group B only received routine care. The primary outcome was the length of postoperative ileus, while the secondary outcomes were the length of hospital stay, in-hospital morbidity, and mortality. The continuous variables were compared using the nonparametric Wilcoxon Rank sum (Mann-Whitney U) test while the categorical outcomes were compared using the chi-squared test in SPSS version 26. The protocol was retrospectively registered with the WHO Pan African Clinical Trial Registry (Number: PACTR202206468032528) on the 1st of June 2022.
Of the 52 participants included in the analysis, the majority were males (80.8%) with a mean age of 34.23 (SD = 11.52) years. There was no statistically significant difference in the baseline characteristics of the study participants between the two groups (P > 0.05 for all). The median duration of postoperative ileus was 21.5 h less in the chewing gum group (28.5 versus 50.0, P = 0.002), while the length of hospital stay was 2.5 days less in the chewing gum group (5.4 versus 7.9, P = 0.007). There was no significant difference noted in the occurrence of complications.
Chewing gum that is readily available and reasonably priced may help shorten the duration of post-operative ileus, which has the extra benefit of enabling early discharge.
术后肠梗阻时间延长与出现更多并发症、住院时间延长及医疗费用增加的风险较高相关。关于咀嚼口香糖对急诊手术患者，尤其是腹膜炎患者肠梗阻持续时间的影响，随机对照试验较少。关于择期手术的研究有令人信服的证据表明，咀嚼口香糖可缩短肠梗阻持续时间。本试验旨在研究咀嚼口香糖对胃十二指肠穿孔剖腹术后发生的术后肠梗阻时长的影响。
多中心随机对照试验。52例患者被随机分为两个治疗组。A组接受常规护理并咀嚼口香糖，而B组仅接受常规护理。主要结局是术后肠梗阻的时长，次要结局是住院时间、住院期间发病率及死亡率。连续变量采用非参数Wilcoxon秩和（Mann-Whitney U）检验进行比较，分类结局在SPSS 26版中采用卡方检验进行比较。该方案于2022年6月1日在世界卫生组织泛非临床试验注册中心进行了回顾性注册（编号：PACTR202206468032528）。
纳入分析的52名参与者中，大多数为男性（80.8%），平均年龄为34.23岁（标准差=11.52）。两组研究参与者的基线特征无统计学显著差异（所有P>0.05）。咀嚼口香糖组术后肠梗阻的中位持续时间短21.5小时（28.5对50.0，P=0.002），而咀嚼口香糖组的住院时间短2.5天（5.4对7.9，P=0.007）。并发症的发生情况无显著差异。
容易获得且价格合理的口香糖可能有助于缩短术后肠梗阻的持续时间，还有助于提前出院。
