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Postoperative ileus after open/laparoscopic sigmoid colectomy contributes to an array of postoperative complications (pain, abdominal distention, and emesis) that reduce patient well-being and increase stay and healthcare costs. The purpose of this prospective, attention-controlled, randomized study was to test whether postoperative gum chewing reduces the duration of postoperative ileus symptoms following elective open/laparoscopic sigmoid colectomy compared to standard care or an attention-control intervention.
Forty-seven patients were randomized into one of 3 groups: (1) standard postoperative care (SC; N=18); (2) standard care and a Telfa-adhesive patch applied to the deltoid region of the upper arm as an attention control (AC; N=16); and (3) standard care and gum chewing (GC; N=13). Age and gender were not found to vary significantly (p=.05) between groups (SC age M=63.3 years, females=61.1%, Males=38.9%; AC age M=60.1 years, females=68.8%, Males=31.2%; GC age M=55.8 years, females=84.6%, Males=25.4%).
Four postoperative outcome variables were measured in minutes and converted to days for ease in reporting: (1) the return of bowel function (determined by the first passage of flatus [SC M=3.42 days; AC M=2.81 days; GC M=2.99 days] and the first bowel movement [SC M=3.33 days; AC M=3.36 days; GC M=5.21 days]); (2) return hunger (SC M =3.06 days; AC M =2.61 days; GC M=2.80 days), ability to tolerate solid food for one meal (SC M=6.19 days; AC M=3.90 days; GC M=4.15 days); (3) length of hospital stay (SC M=6.26 days; AC M=5.53 days; GC M=6.31 days) and (4), major complications (SC=1; AC=1; GC=0).
Postoperative gum chewing was not found to be more effective than standard postoperative care or our attention-control intervention in reducing the duration of postoperative ileus symptoms or complications among patients following open/laparoscopic sigmoid colectomy.