Effects of Gum-chewing on the Recovery of Bowel Motility and Length of Hospital Stay after Surgery for Colorectal Cancer

껌씹기가 대장.직장암환자의 장 절제술 후 장운동 회복 및 재원일수에 미치는 효과

  • Received : 2010.06.20
  • Accepted : 2010.08.02
  • Published : 2010.08.31

Abstract

Purpose: The purpose of this study was to examine the effects of a gum-chewing on the recovery of bowel motility and days of hospitalization after surgery for colorectal cancer. Methods: This study used a non-equivalent control group and non-synchronized design. Thirty-four patients undergoing abdominal surgery for colorectal cancer were assigned to either gum-chewing group (n=17) or control group (n=17). The patients in the gum-chewing group chewed gum for 10 min three times daily from the first postoperative morning until the day they began oral intake. Outcome variables were time of first flatus, time of first bowel movement, and length of hospital stay. Results: Gum-chewing was effective in enhancing the first passage of flatus, but was not effective in enhancing time of bowel movement and length of hospital stay. Conclusion: Gum-chewing can be utilized as a useful nursing intervention to shorten the time of the first flatus of postoperative colectomy.

Keywords

References

  1. Health and Human Services 2009; Cancer Analysis Report 2008.
  2. Stewart D, Waxman K. Management of postoperative ileus. Am J Ther 2007;14:561-6. https://doi.org/10.1097/MJT.0b013e31804bdf54
  3. Tjandra JJ, Chan MK. Systematic review on short-term outcomes of laparoscopic resection for colon and rectosigmoid cancer. Colorectal Dis 2006;8:375-88. https://doi.org/10.1111/j.1463-1318.2006.00974.x
  4. Salimath J, Jones M, Hunt DL, Lane MK. Comparison of return of bowel function and length of stay in patients undergoing laparoscopic versus open colectomy. J Soc Laparoendosc Surg 2007;11:72-5.
  5. Mattei P, Rombeau JL. Review of the pathophysiology and management of postoperative ileus. World J Surg 2006;30: 1382-91. https://doi.org/10.1007/s00268-005-0613-9
  6. Stewart BT, Woods RJ, Collopy BT, Fink RJ, Mackay JR, Keck JO. Early feeding after selective open colorectal resections: a prospective randomized trial. Aust N Z J Surg 1998;68:125-8. https://doi.org/10.1111/j.1445-2197.1998.tb04721.x
  7. Bickel A, Shtamler B, Mizrahi S. Early oral feeding following removal of nasogastric tube in gastrointestinal operations. Arch Surg 1992;126:287-9.
  8. Ha NB, Shin YS, Park JW, Park ST, Ha WS, Choi SK, et al. A study on the tolerability of early postoperative feeding in patients with colorectal cancer. J Korean Surg Soc 1999;57:57-61.
  9. Hartsel PA, Frazee RC, Harrison JB, Smith RW. Early postoperative feeding after selective colorectal surgery. Arch Surg 1997;132:518-21. https://doi.org/10.1001/archsurg.1997.01430290064011
  10. Soffer EE, Adrian TE. Effect of meal composition and sham feeding on duodenojejunal motility in humans. Dig Dis Sci 1992;37: 1009-14. https://doi.org/10.1007/BF01300279
  11. Konturek SJ, Thor P. Relation between duodenal alkaline secretion and motility in fasted and sham-fed dogs. Am J Physiol 1986;251:591-6.
  12. Tern RM, Crawford HE, Stewart WR, Vasey MW, Koch KL. Sham feeding: cephalic-vagal influences on gastric myoelectric activity. Dig Dis Sci 1989;34:521-7. https://doi.org/10.1007/BF01536327
  13. Jepsen JM, Skoubo K, Elsborg L. Rectosigmoid motility response to sham feeding in irritable bowel syndrome. Evidence of a cephalic phase. Scand J Gastroenterol 1989;24:53-6.
  14. Leier H. Does gum chewing help prevent impaired gastric motility in the postoperative period? J Am Acad Nurse Prac 2007; 19:133-6. https://doi.org/10.1111/j.1745-7599.2006.00209.x
  15. Noble EJ, Harris R, Hosie KB, Thome S, Lewis SJ. Gum chewing reduces postoperative ileus? A systematic review and metaanalysis. Int Surg 2009;7:100-5. https://doi.org/10.1016/j.ijsu.2009.01.006
  16. Purkayastha S, Tilney HS, Darzi AW, Tekkis PP. Meta-analysis of randomized studies evaluating chewing gum to enhance postoperative recovery following colectomy. Arch Surg 2008; 143:788-93. https://doi.org/10.1001/archsurg.143.8.788
  17. Asao T, Kuwano H, Nakamura J, Morinaga N, Hirayama I, Ide M. Gum chewing enhances early recovery from postoperative ileus after laparoscopic colectomy. J Am Coll Surg 2002;195: 30-2. https://doi.org/10.1016/S1072-7515(02)01179-1
  18. Schuster R, Grewal N, Greaney GC, Waxman KG. Gum chewing reduces ileus after elective open sigmoid colectomy. Arch Surg 2006;141:174-6. https://doi.org/10.1001/archsurg.141.2.174
  19. Quah HM, Samad A, Neathey AJ, Hay DJ, Maw A. Does gum chewing reduce postoperative ileus following open colectomy for left-sided colon and rectal cancer? A prospective randomized controlled trial. Colorect Dis 2006;8:64-70. https://doi.org/10.1111/j.1463-1318.2005.00884.x
  20. Bang SY, Jung GJ, Jung HY, An S. The effects of gum-chewing on the recovery of bowel movement and oral cavity discomfort after abdominal surgery. J Korean Clin Nurs Res 2008; 14(3):15-25.
  21. Park SY, Chung M. Can gum chewing reduce postoperative ileus after open abdominal surgery? J Korean Surg Soc 2009; 77:306-9. https://doi.org/10.4174/jkss.2009.77.5.306
  22. Chan MK, Law WL. Use of chewing gum in reducing postoperative ileus after elective colorectal resection: A systematic review. Dis Colon Rectum 2007;50:2149-57. https://doi.org/10.1007/s10350-007-9039-9
  23. Milsom JW, Bohm B, Hammerhofer KA, Fazio V, Steiger E, Elson P. A prospective randomized trial comparing laparoscopic versus conventional techniques in colorectal cancer surgery: a preliminary report. J Am Coll Surg 1998;187:46-54. https://doi.org/10.1016/S1072-7515(98)00132-X
  24. Hirayama I, Suzuki M, Ide M, Asao, T, Kuwano H. Gum chewing stimulates bowel motility after surgery for colorectal cancer. Hepatogastroenterology 2006;53:206-8.
  25. Correia TD, da Silva MI, Gomes R. The impact of early nutrition on metabolic response and postoperative ileus. Curr Opin Clin Nutr Metab Care 2004;7:577-83. https://doi.org/10.1097/00075197-200409000-00011
  26. McCormick JT, Garvin R, Caushai P, Simmang C, Gregorcyk S, Huber P, et al. The effects of gum chewing on bowel function and hospital stay after laparascopic vs open colectomy: a multi-institution prospective randomized trial. Am J Coll Surg 2005;3 Suppl:66-7.