title: Influence of gum-chewing on postoperative bowel activity after laparoscopic surgery for gastric cancer: A randomized controlled trial.
abstract: BACKGROUND
  In some studies, gum-chewing was demonstrated to have a beneficial effect on resumption of bowel function; however, other contradictory findings in other studies refute the effects of gum-chewing on peristaltic movements and digestive system stimulation. In addition, most previous studies were after colorectal or gynecology surgery, whereas few reports focused on the effect of gum-chewing after gastrectomy. The aim of this randomized controlled trial was to assess the effectiveness of gum-chewing on postoperative bowel function in patients who had undergone laparoscopic gastrectomy.
  
  
  METHODS
  From March 2014 to March 2016, 75 patients with gastric cancer received elective laparoscopic surgery in Shanghai Tongji hospital and were postoperatively randomly divided into 2 groups: 38 in a gum-chewing (Gum) group and 37 in a control (No gum) group. The patients in the Gum group chewed sugarless gum 3 times daily, each time for at least 15 minutes, until the day of postoperative exhaust defecation.
  
  
  RESULTS
  The mean time to first flatus (83.4 ± 35.6 vs. 79.2 ± 24.2 hours; P = 0.554) and the mean time to first defecation (125.7 ± 41.2 vs. 115.4 ± 34.2 hours; P = 0.192) were no different between the no gum and Gum groups. There was also no significant difference in the incidence of postoperative ileus (P = 0.896) and postoperative hospital stay (P = 0.109) between the 2 groups. The postoperative pain score at 48 hours (P = 0.032) in the Gum group was significantly higher than in the no gum group. There was no significant difference between the 2 groups in regards to patient demographics, comorbidities, duration of surgery, complications, and nausea/vomiting score.
  
  
  CONCLUSIONS
  Gum-chewing after laparoscopic gastrectomy did not hasten the return of gastrointestinal function. In addition, gum-chewing may increase patient pain on the second postoperative day.
authors.affiliation: Department of General Surgery, Tongji Hospital Department of Neurology, East Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China.
authors.forename: Bujun
authors.initials: B
authors.lastname: Ge
authors.forename: Hongmei
authors.initials: H
authors.lastname: Zhao
authors.forename: Rui
authors.initials: R
authors.lastname: Lin
authors.forename: Jialiang
authors.initials: J
authors.lastname: Wang
authors.forename: Quanning
authors.initials: Q
authors.lastname: Chen
authors.forename: Liming
authors.initials: L
authors.lastname: Liu
authors.forename: Qi
authors.initials: Q
authors.lastname: Huang
mesh_terms: D000368:Aged; D002638:Chewing Gum; D005260:Female; D005743:Gastrectomy; D005769:Gastrointestinal Motility; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011446:Prospective Studies; D013274:Stomach Neoplasms / Q000601:surgery*
chemical_list: D002638:Chewing Gum