title: Evaluating the efficacy of current treatments for reducing postoperative ileus: a randomized clinical trial in a single center.
abstract: OBJECTIVE
  Postoperative ileus has been considered an inevitable consequence of abdominal surgery. The aim of the study was to investigate the efficacy of same treatments in resolving postoperative ileus in various surgical approaches.
  
  
  METHODS
  A total of 360 patients underwent abdominal surgery, and was divided into four groups: videolaparoscopic cholecystectomy, laparotomic colo-rectal surgery, laparotomic Hartmann procedure, laparotomic gastric surgery. In each group, patients received different postoperative treatments: chewing gum, olive oil, both, and water. Each group was compared with a control group.
  
  
  RESULTS
  In patients who underwent videolaparoscopic cholecystectomy, median postoperative first passage of flatus and stool in the water group was 10 and 34 hours, respectively (P=0.006, P=0.021) and significantly earlier than in the control group (median postoperative 24 and 72 hours). Postoperative stay for the water group was lower (median day 1, 3rd interquartile 2.5) compared with control (median day 3; 3rd interquartile 7.0, P=0.01). In patients who underwent gastric surgery, median postoperative first passage of stool in the olive oil and chewing gum group was 48 hours, significantly earlier than in the control (median postoperative hour 120, P=0.04). Median time to first passage of flatus and stool was also earlier in the other groups compared with the control group, though this difference was not significant.
  
  
  CONCLUSIONS
  Chewing gum, olive oil or both do not induce a relevant reduction of ileus after surgery. Water may be a safe and inexpensive option in reducing ileus. (United States National Institutes of Health, www.clinicaltrial.gov, number NCT01869231).
authors.affiliation: Department of Surgical and Oncological Sciences University of Palermo, Palermo, Italy - surgeryangela@hotmail.it.
authors.forename: S
authors.initials: S
authors.lastname: Bonventre
authors.forename: A
authors.initials: A
authors.lastname: Inviati
authors.forename: V
authors.initials: V
authors.lastname: Di Paola
authors.forename: P
authors.initials: P
authors.lastname: Morreale
authors.forename: S
authors.initials: S
authors.lastname: Di Giovanni
authors.forename: P
authors.initials: P
authors.lastname: Di Carlo
authors.forename: D
authors.initials: D
authors.lastname: Schifano
authors.forename: G
authors.initials: G
authors.lastname: Frazzetta
authors.forename: G
authors.initials: G
authors.lastname: Gulotta
authors.forename: G
authors.initials: G
authors.lastname: Scerrino
mesh_terms: D000368:Aged; D002638:Chewing Gum; D017081:Cholecystectomy, Laparoscopic; D003106:Colon / Q000601:surgery; D003672:Defecation; D013505:Digestive System Surgical Procedures; D004435:Eating; D005260:Female; D005414:Flatulence; D005769:Gastrointestinal Motility; D006801:Humans; D045823:Ileus / Q000503:physiopathology / Q000517:prevention & control*; D007813:Laparotomy; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D000069463:Olive Oil; D010938:Plant Oils / Q000008:administration & dosage / Q000627:therapeutic use; D011183:Postoperative Complications / Q000503:physiopathology / Q000517:prevention & control*; D020127:Recovery of Function; D012007:Rectum / Q000601:surgery; D013270:Stomach / Q000601:surgery; D014867:Water / Q000008:administration & dosage
chemical_list: D002638:Chewing Gum; D000069463:Olive Oil; D010938:Plant Oils; D014867:Water