title: Effect of sham feeding with gum chewing on postoperative ileus after liver transplantation-a randomized controlled trial.
abstract: Postoperative ileus (POI) is a common complication after major abdominal surgery. Gum chewing has been shown to stimulate bowel motility and decrease duration of POI after abdominal surgery. We evaluated the effect of gum chewing in reducing the time to first flatus and on oral calorie intake in patients undergoing living or deceased donor liver transplantation. Patients were randomized into the sham feeding group or the control group. The sham feeding group chewed two pieces of xylitol flavored gum for 15 minutes, three times a day after extubation until oral nutrition was tolerated. The control group received the same routine care except for the gum chewing. Fifty-nine patients were randomized into the sham feeding group (n=30) or the control group (n=29). There was no difference in the time to first flatus (72 [66.1-82.9] hours vs 69.0 [57.6-77.2] hours, P=.422). Cumulative energy intake (2.8 [5.8-23.2] % vs 10.0 [8.5-15.9] %, P=.695) and length of intensive care unit stay (4.2 [3.9-5.3] days vs 4.0 [6.7-4.5] days, P=.077) were also similar. In conclusion, sham feeding with gum chewing did not shorten the duration of POI nor facilitate oral intake after liver transplantation. (Clinicaltrials.gov number: NCT 01956643).
authors.affiliation: Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea.
authors.forename: Hannah
authors.initials: H
authors.lastname: Lee
authors.affiliation: Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea.
authors.forename: Chan Woo
authors.initials: CW
authors.lastname: Cho
authors.affiliation: Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea.
authors.forename: Susie
authors.initials: S
authors.lastname: Yoon
authors.affiliation: Department of Surgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea.
authors.forename: Kyung-Suk
authors.initials: KS
authors.lastname: Suh
authors.affiliation: Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea. hogeol@gmail.com.
authors.forename: Ho Geol
authors.initials: HG
authors.lastname: Ryu
mesh_terms: D000328:Adult; D000368:Aged; D002638:Chewing Gum; D005260:Female; D006801:Humans; D045823:Ileus / Q000209:etiology / Q000628:therapy*; D016014:Linear Models; D016031:Liver Transplantation; D008297:Male; D008409:Mastication; D008875:Middle Aged; D011182:Postoperative Care / Q000379:methods*; D011183:Postoperative Complications / Q000628:therapy*; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D002638:Chewing Gum
keywords: chewing gum; energy intake; first flatus; liver transplantation; postoperative ileus