Randomized clinical trial of chewing gum after laparoscopic colorectal resection

BackgroundChewing gum may enhance intestinal motility after surgery. This trial studied whether chewing gum could lead to a further reduction in ileus in patients who had a laparoscopic colorectal resection and followed an enhanced recovery programme. MethodsPatients undergoing laparoscopic colorectal resection were randomized to a control or intervention group. Patients in the control group received a standardized recovery programme. Patients in the intervention group were, in addition, given chewing gum three times daily from day 1 until discharge. Primary outcome measures were time to first flatus and first bowel motion. Time to feeling hungry and hospital stay were secondary outcome measures. ResultsForty-one patients were randomized into each group. Thirty-seven patients underwent rectal resection and 45 had a colonic resection. Time to passage of flatus was shorter (18 versus 34h; P=0007), first bowel motion occurred earlier (19 versus 44h; P=0001) and time to feeling hungry was earlier (16 versus 25h; P=0001) in the intervention group. There was no difference in the duration of hospital stay (5days in the intervention group versus 55days in the control group). Subgroup analyses revealed that the benefits of chewing gum were clearer in patients who had a colonic resection, with a shorter time to first flatus (20 versus 35h; P=0043), first bowel motion (19 versus 53h; P=0014) and feeling hungry (14 versus 40h; P=0001). No adverse events were attributed to chewing gum. ConclusionChewing gum is a simple intervention that speeds intestinal transit in patients managed with a recovery programme after laparoscopic colorectal resection. Registration number: NCT02419586 (). Simple way to accelerate recovery