title: Chewing gum reduces postoperative ileus following abdominal surgery: a meta-analysis of 17 randomized controlled trials.
abstract: OBJECTIVE
  Chewing gum proposal has been used in surgery to reduce postoperative ileus for more than 10 years; however, the efficacy remains imprecise. The aim of this study was to accurately assess whether the use of the chewing gum could reduce duration of postoperative ileus following the abdominal surgery.
  
  
  METHODS
  A systematic review was conducted in Medline, EMBASE, and the Cochrane Library through December 2012 to identify randomized controlled trials comparing with and without the use of chewing gum in patients undergoing abdominal surgery. The outcome of interest was time to flatus, time to bowel movement, and length of stay. Subgroup analyses were performed to examine the impact of different studies structural design. Cumulative meta-analyses were used to examine how the evidence has changed over time.
  
  
  RESULTS
  Seventeen randomized controlled trials involving 1374 participants were included. Overall time (in days) for the patients to pass flatus (weighted mean difference [WMD], -0.31; 95% confidence interval [CI], -0.43 to -0.19; P = 0.000); time to bowel movement (WMD, -0.51; 95% CI, -0.73 to -0.29; P = 0.000); and length of stay (WMD, -0.72; 95% CI, -1.02 to -0.43; P = 0.000) were significantly reduced in the treatment group. However, both of these results demonstrated significant heterogeneity. No evidence of publication bias was observed. Cumulative meta-analysis showed that chewing gum reduces duration of postoperative ileus that has been available for over 6 years.
  
  
  CONCLUSIONS
  Results of the meta-analysis suggest that chewing gum following abdominal surgery offers benefits in reducing the time of postoperative ileus.
authors.affiliation: Department of Clinical Laboratory, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China. lishan8858@163.com
authors.forename: Shan
authors.initials: S
authors.lastname: Li
authors.forename: Yanqiong
authors.initials: Y
authors.lastname: Liu
authors.forename: Qiliu
authors.initials: Q
authors.lastname: Peng
authors.forename: Li
authors.initials: L
authors.lastname: Xie
authors.forename: Jian
authors.initials: J
authors.lastname: Wang
authors.forename: Xue
authors.initials: X
authors.lastname: Qin
mesh_terms: D000005:Abdomen / Q000601:surgery*; D002638:Chewing Gum; D006801:Humans; D045823:Ileus / Q000517:prevention & control*; D016239:MEDLINE; D008409:Mastication / Q000502:physiology*; D011183:Postoperative Complications / Q000517:prevention & control*; D016032:Randomized Controlled Trials as Topic; D013514:Surgical Procedures, Operative
chemical_list: D002638:Chewing Gum