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Este resumen Epistemonikos (Living FRISBEE: Living FRIendly Summary of the Body of Evidence using Epistemonikos) es una actualización del resumen publicado en Noviembre de 2014, basado en 4 nuevas revisiones sistemáticas aparecidas con posterioridad. El íleo postoperatorio es una condición común que retrasa la recuperación luego de una cirugía abdominal. El uso precoz de goma de mascar, como método de alimentación fingida, estimularía la peristalsis permitiendo una alimentación más precoz.
Utilizando la base de datos Epistemonikos, la cual es mantenida mediante búsquedas en 30 bases de datos, identificamos 18 revisiones sistemáticas que en conjunto incluyen 81 estudios aleatorizados. Realizamos un metanálisis y tablas de resumen de los resultados utilizando el método GRADE. Concluimos que la goma de mascar probablemente disminuye el tiempo de hospitalización luego de una cirugía abdominal.
Este resumen Epistemonikos (Living FRISBEE: Living FRIendly Summary of the Body of Evidence using Epistemonikos) es una actualización del resumen publicado en Noviembre de 2014 (doi: 10.5867/medwave.2014.11.6058), basado en cuatro nuevas revisiones sistemáticas aparecidas con posterioridad, incluyendo una revisión Cochrane que aporta 58 estudios controlados aleatorizados no identificados por ninguna de las revisiones previas.
La nueva evidencia incorporada en este resumen lleva a un aumento en la certeza de la evidencia para el desenlace principal de baja a moderada, y a una estimación levemente mayor de la magnitud del beneficio, con la consecuente modificación en los mensajes clave y las consideraciones para la toma de decisión.
El íleo postoperatorio es una condición común entre los pacientes sometidos a cirugía, especialmente intraabdominal. Esta alteración se debe a un estado de obstrucción intestinal transitorio por un defecto en la actividad propulsiva de todo o parte del tubo digestivo.
Si bien la mayor parte de los casos se resuelve a los poco días, en algunos puede prolongarse el período de recuperación, constituyendo un íleo paralítico postoperatorio, el cual se acompaña de náuseas, vómitos, distensión abdominal y dolor, aumentando los días de hospitalización, gasto de insumos, días de ayuno, entre otros.
El uso precoz de goma de mascar, como método de alimentación fingida, sería beneficioso para estimular la peristalsis y disminuir el tiempo de recuperación del íleo post operatorio y la incidencia de íleo paralítico, permitiendo una alimentación más precoz y eventualmente una disminución de la estadía hospitalaria.
Utilizamos la base de datos Epistemonikos, la cual es mantenida mediante búsquedas en 30 bases de datos, para identificar revisiones sistemáticas y sus estudios primarios incluidos. Con esta información generamos un resumen estructurado, siguiendo un formato preestablecido, que incluye mensajes clave, un resumen del conjunto de evidencia (presentado como matriz de evidencia en Epistemonikos), metanálisis del total de los estudios, tablas de resumen de resultados con el método GRADE, y tabla de otras consideraciones para la toma de decisión.
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Mensajes clave
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Cuál es la evidencia. |
Encontramos 18 revisiones sistemáticas [1-18] que en conjunto identificaron 83 estudios (reportados en 98 referencias [19-116], incluyendo 81 estudios controlados aleatorizados). La información en esta tabla y el resumen en general hacen referencia a estos últimos. |
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Qué tipo de pacientes incluyeron los estudios |
Veinte estudios evaluaron pacientes sometidos a cirugía colorrectal, 15 a cesárea, tres a apendicectomía, cuatro a colecistectomía, y los 39 restantes incluyeron pacientes con otras cirugías abdominales o no se restringieron a un solo tipo de cirugía. Todos los estudios excepto dos [35],[114], evaluaron población adulta. |
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Qué tipo de intervenciones incluyeron los estudios |
La goma de mascar se administró durante cinco minutos a una hora (mediana 20 minutos). La frecuencia fue 12 veces al día en siete estudios, ocho veces al día en dos, seis veces al día en tres, cuatro veces al día en 11, tres veces en 55 estudios y en un estudio fue administrado solo por una vez (mediana tres veces al día). |
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Qué tipo de desenlaces midieron |
Tiempo hasta la expulsión de gases por boca, tiempo hasta tener deposiciones, tiempo hasta el primer movimiento intestinal, tiempo de hospitalización, complicaciones, tolerancia de la goma de mascar, costos. |
La información sobre los beneficios de la goma de mascar está basada en 81 estudios aleatorizados, de los cuales 56 reportan el desenlace tiempo de hospitalización, que en total incluyen 5278 pacientes.
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A quién se aplica y a quién no se aplica esta evidencia |
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| Sobre los desenlaces incluidos en este resumen |
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| Balance riesgo/beneficio y certeza de la evidencia |
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| Qué piensan los pacientes y sus tratantes |
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| Consideraciones de recursos |
| Factibilidad e implementación |
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Diferencias entre este resumen y otras fuentes |
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| ¿Puede que cambie esta información en el futuro? |
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Mediante métodos automatizados y colaborativos recopilamos toda la evidencia relevante para la pregunta de interés y la presentamos en una matriz de evidencia.
Siga el enlace para acceder a la versión interactiva Chewing gum for the amelioration of postoperative ileus
Si con posterioridad a la publicación de este resumen se publican nuevas revisiones sistemáticas sobre este tema, en la parte superior de la matriz se mostrará un aviso de “nueva evidencia”. Si bien el proyecto contempla la actualización periódica de estos resúmenes, los usuarios están invitados a comentar en Medwave o contactar a los autores mediante correo electrónico si creen que hay evidencia que motive una actualización más rápida.
Luego de crear una cuenta en Epistemonikos, al guardar las matrices recibirá notificaciones automáticas cada vez que exista nueva evidencia que potencialmente responda a esta pregunta. El detalle de los métodos para elaborar este resumen están descritos aquí: http://dx.doi.org/10.5867/medwave.2014.06.5997.
La Fundación Epistemonikos es una organización que busca acercar la información a quienes toman decisiones en salud, mediante el uso de tecnologías. Su principal desarrollo es la base de datos Epistemonikos (www.epistemonikos.org).
Los resúmenes de evidencia siguen un riguroso proceso de revisión por pares interno.
Declaración de conflictos de intereses
Los autores declaran no tener conflictos de intereses con la materia de este artículo.
Matriz de evidencia
Esta obra de Medwave está bajo una licencia Creative Commons Atribución-NoComercial 3.0 Unported. Esta licencia permite el uso, distribución y reproducción del artículo en cualquier medio, siempre y cuando se otorgue el crédito correspondiente al autor del artículo y al medio en que se publica, en este caso, Medwave.
This Living FRISBEE (Living FRIendly Summary of the Body of Evidence using Epistemonikos) is an update of the summary published in November 2014, based on four new systematic reviews published since then. Postoperative ileus is common condition that delays recovery after an abdominal surgery. Early use of sham feeding with chewing gum stimulates peristalsis and would allow an earlier nutrition. Searching in Epistemonikos database, which is maintained by screening 30 databases, we identified 18 systematic reviews including 81 randomized trials. We combined the evidence using meta-analysis and generated a summary of findings following the GRADE approach. We concluded that chewing gum probably reduces the length of hospital stay after an abdominal surgery.
Autores:
Gabriel Rada[1,2,3,4,5], José Viñuela[2,5]
Citación: Rada G, Viñuela J. Does chewing gum improve recovery after an abdominal surgery? –First update. Medwave 2015 Jun;15(Suppl 1):e6162 doi: 10.5867/medwave.2015.6162
Fecha de publicación: 18/6/2015
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Chan MK, Law WL. Use of chewing gum in reducing postoperative ileus after elective colorectal resection: a systematic review. Dis Colon Rectum. 2007 Dec;50(12):2149-57. | PubMed |Craciunas L, Sajid MS, Ahmed AS. Chewing gum in preventing postoperative ileus in women undergoing caesarean section: a systematic review and meta-analysis of randomised controlled trials. BJOG. 2014 Jun;121(7):793-9; discussion 799. | CrossRef | PubMed |de Castro SM, van den Esschert JW, van Heek NT, Dalhuisen S, Koelemay MJ, Busch OR, et al. A systematic review of the efficacy of gum chewing for the amelioration of postoperative ileus. Dig Surg. 2008;25(1):39-45. | CrossRef | PubMed |Fitzgerald JE, Ahmed I. Systematic review and meta-analysis of chewing-gum therapy in the reduction of postoperative paralytic ileus following gastrointestinal surgery. World J Surg. 2009 Dec;33(12):2557-66. | CrossRef | PubMed |Ho YM, Smith SR, Pockney P, Lim P, Attia J. A meta-analysis on the effect of sham feeding following colectomy: should gum chewing be included in enhanced recovery after surgery protocols? Dis Colon Rectum. 2014 Jan;57(1):115-26. | CrossRef | PubMed |Hochner H, Tenfelde SM, Abu Ahmad W, Liebergall-Wischnitzer M. Gum chewing and gastrointestinal function following caesarean delivery: a systematic review and meta-analysis. J Clin Nurs. 2015 Apr 7. | CrossRef | PubMed |Li S, Liu Y, Peng Q, Xie L, Wang J, Qin X. Chewing gum reduces postoperative ileus following abdominal surgery: a meta-analysis of 17 randomized controlled trials. J Gastroenterol Hepatol. 2013 Jul;28(7):1122-32. | CrossRef | PubMed |Noble EJ, Harris R, Hosie KB, Thomas S, Lewis SJ. Gum chewing reduces postoperative ileus? A systematic review and meta-analysis. Int J Surg. 2009
Apr;7(2):100-5. | CrossRef | PubMed |Parnaby CN, MacDonald AJ, Jenkins JT. Sham feed or sham? A meta-analysis of randomized clinical trials assessing the effect of gum chewing on gut function after elective colorectal surgery. Int J Colorectal Dis. 2009 May;24(5):585-92. | CrossRef | PubMed |Purkayastha S, Tilney HS, Darzi AW, Tekkis PP. Meta-analysis of randomized studies evaluating chewing gum to enhance postoperative recovery following colectomy. Arch Surg. 2008 Aug;143(8):788-93. | CrossRef | PubMed |Short V, Herbert G, Perry R, Atkinson C, Ness AR, Penfold C, et al.. Chewing gum for postoperative recovery of gastrointestinal function. Cochrane Database Syst Rev. 2015 Feb 20;2:CD006506. | CrossRef | PubMed |Su'a BU, Pollock TT, Lemanu DP, MacCormick AD, Connolly AB, Hill AG. Chewing gum and postoperative ileus in adults: a systematic literature review and meta-analysis. Int J Surg. 2015 Feb;14:49-55. | CrossRef | PubMed |Vásquez W, Hernández AV, Garcia-Sabrido JL. Is gum chewing useful for ileus after elective colorectal surgery? A systematic review and meta-analysis of randomized clinical trials. J Gastrointest Surg. 2009 Apr;13(4):649-56. | CrossRef | PubMed |Wallström A, Frisman GH. Facilitating early recovery of bowel motility after colorectal surgery: a systematic review. J Clin Nurs. 2014 Jan;23(1-2):24-44. | CrossRef | PubMed |Wang XJ, Chi P. [Effect of chewing gum on the promotion of intestinal function recovery after colorectal surgery: a meta-analysis]. Zhonghua Wei Chang Wai Ke Za | PubMed |Yin Z, Sun J, Liu T, Zhu Y, Peng S, Wang J. Gum chewing: another simple potential method for more rapid improvement of postoperative gastrointestinal function. Digestion. 2013;87(2):67-74. | CrossRef | PubMed |Yuan Y, Zhao H, He J, Gong D. [Chewing Gum in Promoting Bowel Recovery after Cesarean Section: A Systematic Review]. Chin J Evidence-Based Med. 2011;11(4):427-432 Zhu YP, Wang WJ, Zhang SL, Dai B, Ye DW. Effects of gum chewing on postoperative bowel motility after caesarean section: a meta-analysis of randomised controlled trials. BJOG. 2014 Jun;121(7):787-92. | CrossRef | PubMed |Chewing gum aids recovery after colon resection. OR Manager. 2005;21(12):11. Chewing gum after colectomy. American Journal of Nursing. 2006;106(9):72JK-L. Gum chewing reduces ileus after colectomy. OR Manager.2006;22(4):32. Postop bowel function: chewing gum may speed recovery. Nursing Administration Quarterly. 2006;36(5):34. Abd-El-Maeboud KH, Ibrahim MI, Shalaby DA, Fikry MF. Gum chewing stimulates early return of bowel motility after caesarean section. BJOG. 2009 Sep;116(10):1334-9. | CrossRef | PubMed |Abdollahi AA, Yazdi K, Behnampour N, Niazi M. The effect of chewing gum on bowel movements after appendectomy. Arak Medical University Journal. 2011;13(4):38-43. Abdollahi AA, Yazdi K, Behnampour N, Niazi M. Effect of gum-chewing on the movement of intestines after abdominal resection and length of hospital stay. Int J Hosp Res. 2013 2013;2(3):125-9. Akhlaghi F, Pourjavad M, Mansouri A, Tara F, Vahedian M. Effect of Gum Chewing on Prevention of Post Cesarean Ileus. Hayat. 2009 2009;14(2):35-40. Allen G. Evidence for practice. Effect of gum chewing on postoperative ileus. AORN Journal. 2003 2003;77(2):461. Asao T, Kuwano H, Nakamura J, Morinaga N, Hirayama I, Ide M. Gum chewing enhances early recovery from postoperative ileus after laparoscopic colectomy. J Am Coll Surg. 2002 Jul;195(1):30-2. | PubMed |Askarpour S, Shoushtari M, Saadati M. Study of the effect of early feeding, chewing gums, and laxative on ileus in patients who underwent open cholecystectomy. The Internet J Surg. 2009;22(2). Atkinson C, Penfold C, Ness A, Longman R, Thomas S, Hollingworth W, et al. LB024-MON: a randomised trial of chewing gum to reduce post-operative ileus. Clin Nutr. 2014 2014;33:S260. | CrossRef |Bahena-Aponte JA, Cárdenas-Lailson E, Chávez-Tapia N, Flores-Gama F. [Usefulness of chewing gum for the resolution of postoperative ileus in left colon resections]. Rev Gastroenterol Mex. 2010 Oct-Dec;75(4):369-73. Spanish. | PubMed |Bonventre S, Inviati A, Di Paola V, Morreale P, Di Giovanni S, Di Carlo P, Schifano D, Frazzetta G, Gulotta G, Scerrino G. Evaluating the efficacy of current treatments for reducing postoperative ileus: a randomized clinical trial in a single center. Minerva Chir. 2014 Feb;69(1):47-55. | PubMed |Cabrera GTO, Justiniano K, Herrera L, Ortiz MV, Vargas VC. [Effectiveness of chewing gum in restoring intestinal transit for postoperative paralytic ileus: a prospective randomised study]. Panam J Trauma, Crit Care Emerg Surg. 2012;1(3):193-7. Cao R, Zuo Y, Chen H, Zhu X, Kang Z. Colorectal cancer patients chewing gum on intestinal function. Today Nurse. 2008;11:45-6. Cavuşoğlu YH, Azili MN, Karaman A, Aslan MK, Karaman I, Erdoğan D, et al. Does gum chewing reduce postoperative ileus after intestinal resection in children? A prospective randomized controlled trial. Eur J Pediatr Surg. 2009 Jun;19(3):171-3. | CrossRef | PubMed |Chen L, Xie S, Xiao Y, Dan Y. Early chewing gum on the bile duct exploration postoperative recovery of bowel movements. Journal of Nurses Training. 2011;26(11):1046-7. Chen X, Sun D. Influence of chewing gum on recovery of gastrointestinal function after gastric resection. West China Med J. 2012;24(10):2003-4. Chen Y, Ma Z, Lu R, Yao H, Peng N. Clinical Effects of Early Chewing Gum in Promoting Recovery of Gastrointestinal Function. Nur J Chin People's Liberation Army.2010;27(16):1275-6. Choi H, Kang SH, Yoon DK, Kang SG, Ko HY, Moon du G, Park JY, Joo KJ, Cheon J. Chewing gum has a stimulatory effect on bowel motility in patients after open or robotic radical cystectomy for bladder cancer: a prospective randomized comparative study. Urology. 2011 Apr;77(4):884-90. | CrossRef | PubMed |Choi H, Kim JH, Park JY, Ham BK, Shim Js, Bae JH. Gum chewing promotes bowel motility after a radical retropubic prostatectomy. Asia Pac J Clin Oncol. 2014
Mar;10(1):53-9. | CrossRef | PubMed |Chou SJ, Lin CH, Hsieh HF, Yu JC, Chen TW, Chan DC. Gum chewing in patients with subtotal gastrectomy. Chir Gastroenterol. 2006 2006;22(4):269-71. | CrossRef |Chuamor K, Thongdonjuy J. Effectiveness of standard nursing care with gum chewing to reduce bowel ileus in post-operative gynecologic patients: randomized controlled trials. Siriraj Medical Journal. 2014;66(2):33-8. | Link |Crainic C, Erickson K, Gardner J, Haberman S, Patten P, Thomas P, Hays V. Comparison of methods to facilitate postoperative bowel function. Medsurg Nurs. 2009 Jul-Aug;18(4):235-8.
| PubMed |Doyle-Munoz J, Forrester DA, McTigue T, D'Andrea S, Natale-Ryan A. The efficacy of gum chewing in reducing postoperative ileus. J Wound Ostomy Continence Nurs. 2014 May-Jun;41(3):227-32. | CrossRef | PubMed |Ertas IE, Gungorduk K, Ozdemir A, Solmaz U, Dogan A, Yildirim Y. Influence of gum chewing on postoperative bowel activity after complete staging surgery for gynecological malignancies: a randomized controlled trial. Gynecol Oncol. 2013 Oct;131(1):118-22. | CrossRef | PubMed |Fan Q, Geng X, Chen H, Yu J, Hu M, Yi J. Effects of chewing gum on recovery of gastrointestinal motility in patients undergoing total resection of colorectal cancer. Med J National Defending Forces in Southwest China. 2009;19(12):1240-1. Forrester DA, Doyle-Munoz J, McTigue T, D'Andrea S, Natale-Ryan A. The efficacy of gum chewing in reducing postoperative ileus: a multisite randomized controlled trial. J Wound Ostomy Continence Nurs. 2014 May-Jun;41(3):227-32. | CrossRef | PubMed |Garshasbi A, Behboudi S. The effect of Gum chewing on postoperative ileus after cesarean section. Society for Obstetric Anesthesia and Perinatology (SOAP) 42nd Annual Meeting; 2011. Garvin R, McCormick JT, Read TE, Papasavas PK, Caushaj PF. Gum chewing accelerates recovery of bowel function after intestinal resection: Multi-institutional prospective randomized trial. American J Gastroenterol. 2005;100(9):S269. | CrossRef |Ghafouri A, Soroush AR, Moeini N, Hedayat A, Khourgami ZH. The efficacy of sugar free gum chewing after upper gi tract operation on ileus: a clinical trial. Iranian Journal of Surgery. 2008;16(1):79-84. | Link |Gong L. Chewing gum on gastrointestinal surgery patients after bowel function. Chin J Aesthetic Med. 2011;20(Z2):325-6. Guangqing Y, Xiaomei Y, Chunlan W. Influence of chewing gum on gastrointestinal function of postoperative patients in obstetrics and gynecology department after undergoing minimally invasive surgery. Chinese Nurs Res. 2011;25(4):311-2. | Link |Han Z, Zhao H, Liu C, Jin Q. Randomized controlled study on the role of chewing gum in bowel function recovery for patients with leiomyoma after surgery. China Medical Herald. 2011;8(28):37-9. Harma MI, Barut A, Arikan, II, Harma M. Gum-chewing speeds return of first bowel sounds but not first defecation after cesarean section. Anatol J Obstet Gynecol. 2009;1:1-3. Hirayama I, Suzuki M, Ide M, Asao T, Kuwano H. Gum-chewing stimulates bowel motility after surgery for colorectal cancer. Hepatogastroenterology. 2006 Mar-Apr;53(68):206-8 | PubMed |Huang W, Yu X. Influence of gum chewing on gastrointestinal function of patients after undergoing laparoscopic appendectomy. Chinese Nursing Research. 2012;26(23):2153-4. | Link |Huang Y, Ling Y, Huang Q, Huang M. Three different methods of care for elderly postoperative gastrointestinal function recovery of gastrointestinal comparison.J Youjiang Medical University for Nationalities. 2012;34(3):442-4. Huang Y, Ling Y, Huang Q, Huang M. Influence of chewing gum on recovery of gastrointestinal function in elder patients after gastrointestinal operation. Chinese Journal of Misdiagnostics. 2012;12(17):4500-2. Husslein H, Franz M, Gutschi M, Worda C, Polterauer S, Leipold H. Postoperative gum chewing after gynecologic laparoscopic surgery: a randomized controlled trial. Obstet Gynecol. 2013 Jul;122(1):85-90.
| CrossRef | PubMed |Jakkaew B, Charoenkwan K. Effects of gum chewing on recovery of bowel function following cesarean section: a randomized controlled trial. Arch Gynecol Obstet. 2013 Aug;288(2):255-60. | CrossRef | PubMed |Jernigan AM, Chen CC, Sewell C. A randomized trial of chewing gum to prevent postoperative ileus after laparotomy for benign gynecologic surgery. Int J Gynaecol Obstet. 2014 Dec;127(3):279-82. | CrossRef | PubMed |Jin Q, Huang J, Songlin Y, Wang C, Yin X. Chewing gum for kidney patients after recovery of gastrointestinal function. Chinese Journal of Modern Nursing. 2010;16(23):2833-4. Kafali H, Duvan CI, Gözdemir E, Simavli S, Onaran Y, Keskin E. Influence of gum chewing on postoperative bowel activity after cesarean section. Gynecol Obstet Invest. 2010;69(2):84-7. | CrossRef | PubMed |Kouba EJ, Wallen EM, Pruthi RS. Gum chewing stimulates bowel motility in patients undergoing radical cystectomy with urinary diversion. Urology. 2007 Dec;70(6):1053-6. | PubMed |Ledari FM, Barat S, Delavar MA. Chewing gums has stimulatory effects on bowel function in patients undergoing cesarean section: a randomized controlled trial. Bosn J Basic Med Sci. 2012 Nov;12(4):265-8. | PubMed |Lee DDK, Runowicz CD, Chambers JT, Langer O. Efficacy of gum chewing in improving the recovery of bowel function after major gynecologic surgery. Obstetrics and Gynecology. 2004;103(4):21S. Li L, Cai L. Observation on effect of chewing gum in mouth care for patients after underwent gastrointestinal operation. Chinese Nursing Research. 2007;21(5):417-8. Li M. [Chewing gum can promote the recovery of intestinal function]. Chinese Manipulation & Rehabilitation Medicine. 2012;3(11):89-90. Li Y. [Chewing gum on the impact of early postoperative gastrointestinal function in patients with colon cancer]. World Health Digest. 2012;41:69-70. Liang J-h, Gao T, Han W-w, Zhang Y, Liu S-l, Dai Q-l. The clinical observation of enhancing recovery of gastrointestinal function after cesarean section by gum chewing. Journal of Tongji University(Medical Science). 2007;28(2):81-3. Lim P, Morris OJ, Nolan G, Moore S, Draganic B, Smith SR. Sham feeding with chewing gum after elective colorectal resectional surgery: a randomized clinical trial. Ann Surg. 2013 Jun;257(6):1016-24. | CrossRef | PubMed |Lu D, Liu Q, Shi G. Gum chewing stimulates early return of bowel motility after gynecologic laparoscopic surgery. Fertility and sterility. 2011;96(3 SUPPL. 1):S32. Lu L, Zhao A. "False eat" diet promote cesarean section with recovery of gastrointestinal function and clinical studies lactation. Journal of Nurses Training. 2010;25(23):2158-9. Lu Q, Wu W, Yang L, Zhao X, Zhong Z, Wang HY, et al. The effect of gum chewing on bowel motility in patients after radical cystectomy with urinary diversion. China Journal of Modern Medicine. 2011;21(10):1255-7. Luo S-q, Wu C-l, Yang X-m, Lei L-x, Deng H-r, Li H. Effect of chewing gum after cesarean section on restoration of gastrointestinal function. Chinese Journal of Modern Nursing. 2010;16(24):2948-9. Marwah S, Singla S, Tinna P. Role of gum chewing on the duration of postoperative ileus following ileostomy closure done for typhoid ileal perforation: a prospective randomized trial. Saudi J Gastroenterol. 2012 Mar-Apr;18(2):111-7. | CrossRef | PubMed |Matros E, Rocha F, Zinner M, Wang J, Ashley S, Breen E, Soybel D, Shoji B, Burgess A, Bleday R, Kuntz R, Whang E. Does gum chewing ameliorate postoperative ileus? Results of a prospective, randomized, placebo-controlled trial. J Am Coll | PubMed |McCormick JT. Gum in the postoperative setting: something to chew on. Dis Colon Rectum. 2013 Mar;56(3):273-4.
| CrossRef | PubMed |McCormick JT, Garvin R, Caushaj P, Simmang C, Gregorcyk S, Huber P, et al. The effects of gum chewing on bowel function and hospital stay after laparoscopic vs open colectomy: a multi-institution prospective randomised trial. Journal of the American College of Surgeons. 2005;201(3):S66-S7. | CrossRef |Mohsenzadeh Ledari F, Barat S, Delavar MA, Banihosini SZ, Khafri S. Chewing sugar-free gum reduces ileus after cesarean section in nulliparous women: a randomized clinical trial. Iran Red Crescent Med J. 2013 Apr;15(4):330-4. | CrossRef | PubMed |Ngowe MN, Eyenga VC, Kengne BH, Bahebeck J, Sosso AM. Chewing gum reduces postoperative ileus after open appendectomy. Acta Chir Belg. 2010 Mar-Apr;110(2):195-9. | PubMed |Park SY, Chung M. Can gum chewing reduce postoperative ileus after open abdominal surgery? Journal of the Korean Surgical Society. 2009;77(5):206-9. | CrossRef |Pilehvarzadeh M, Shamsi A, Salari S, Rafeti F, Hosseinrezaii H, Ebadi A. Effect of gum chewing in the reduction of paralytic ileus following cholecystectomy. Journal of Qazvin University of Medical Sciences. 2014;17(6):24-9. | CrossRef |Qiao J-j. Clinical observation of chewing gum in promoting the recovery of gastrointestinal function after gastrointestinal disease surgery. Journal of Clinical Medicine in Practice. 2011;15(14):45-6. Qiu F, Ren X. Chewing gum after abdominal surgery in gynecologic patients with gastrointestinal function recovery application. Modern Nursing. 2006;12(17):1624-5. Quah HM, Samad A, Neathey AJ, Hay DJ, Maw A. Does gum chewing reduce postoperative ileus following open colectomy for left-sided colon and rectal cancer? A prospective randomized controlled trial. Colorectal Dis. 2006 Jan;8(1):64-70.
| PubMed |Rashad WAE, Yousef S. Effect of sugarless gum chewing on intestinal movement after cesarean section. Life Science Journal. 2013;10(4):3257-61.
| Link |Ray KL, Estes JM, Huh WK. Prospective, randomized trial of postoperative gum-chewing and return of bowel function in gynecology. Obstetrics and Gynecology.2008;111(4):7S-8S. Ren Y, Qin X. Effect of chewing gum on the time of anal exhaust after laparoscopic cholecystectomy. Journal of Qilu Nursing. 2010;16(20):4-5. Ren Y, Qin X, Dai X. Effect of chewing gum on gastrointestinal function after laparoscopic abdominal surgery. Chinese Journal of Practical Nursing. 2010;26(26):68-70. Rocha FG, Matros E, Ashley SW, Breen E, Shoji BT, Soybel DI, et al. Does gum chewing ameliorate postoperative ileus? Results of a prospective, randomized placebo-controlled trial. Gastroenterology. 2005;128(4):A800. Safdari-Dehcheshmehi F, Salehian T, Parvin N, Akbari N. Comparison of the effects of gum chewing with those of early initiation of oral feeding and routine regimen on recovery of bowel function in primiparous women after cesarean section. Scientific Journal of Kurdistan University of Medical Sciences. 2011;16(2):Pe9-Pe15. Satij B. Evaluation of gum chewing on the return of bowel functions in cesarean-delivery patients. Obstetrics and gynecology. 2006;107(4 Suppl):10S. Schluender SS, Gurland BHG, Divino CD, Horovitz JH, Adler HA, Chernobelsky LC, et al. Gum chewing does not enhance the return of bowel function in patients undergoing elective colon resection in a randomized blinded pilot study. Colorectal disease. 2005;7(Suppl 1):92. Schuster R, Grewal N, Greaney GC, Waxman K. Gum chewing reduces ileus after elective open sigmoid colectomy. Arch Surg. 2006 Feb;141(2):174-6. | PubMed |Schweizer W, Häne R. Sham-feeding of patients with chewing gum after abdominal operations. British Journal of Surgery. 2010 2010;97(S3):8. Shang H, Yang Y, Tong X, Zhang L, Fang A, Hong L. Gum chewing slightly enhances early recovery from postoperative ileus after cesarean section: results of a prospective, randomized, controlled trial. Am J Perinatol. 2010 May;27(5):387-91.
| CrossRef | PubMed |Smith SR, Lim P, Draganic B. Effect of gum chewing on gastrointestinal recovery after laparoscopic colorectal resectional surgery: a prospective randomized clinical trial. Royal Australasian College of Surgeons Annual Scientific Congress, Perth, Western Australia (Published in: ANZ journal of surgery); 2010: A17. Sun L, Gong S, Gong H, Zhang Y. Chewing gum used in abdominal surgery and postoperative care observation. Today Nurse. 2005 2005;7:11-2. Tan Y, Tang X. [Chewing gum after abdominal surgery for gynecological promote recovery of gastrointestinal function]. Today Nurse. 2011;10:47-8. Terzioglu F, Şimsek S, Karaca K, Sariince N, Altunsoy P, Salman MC. Multimodal interventions (chewing gum, early oral hydration and early mobilisation) on the intestinal motility following abdominal gynaecologic surgery. J Clin Nurs. 2013 Jul;22(13-14):1917-25. | CrossRef | PubMed |Tian M. Effect of chewing gums on gastrointestinal function of rectal cancer patients undergoing surgical operations. Modern Clinical Nursing. 2013;12(2):45-7. Wang H. Chewing gum to promote recovery of bowel movement after abdominal surgery observation. Journal of Qiqihar Medical College. 2009;30(4):492. Wang S, Hou Y, Dong S, Liu B, Zhang K. A randomized controlled trial of chewing gum to promote postoperative bowel recovery for patients with rectal cancer. Sichuan Medical Journal. 2011;32(12):1956-8. Wang X, Liao H, Gao L, Ma Y, Zhang L. Chewing gum on recovery of gastrointestinal function after abdominal surgery impact. Journal of Nurses Training. 2008;23(10):938-9. Wang X, Ren Y, Qin X, Dai X. Influence of sham feeding on motilin and evacuating time after accepting cesarean section. Chinese Nursing Research. 2011;25(8):682-3. Watson H, Griffiths P, Lamparelli M, Watson M. Does chewing (gum) aid recovery after bowel resection? A randomised controlled trial (RCT). Colorectal Disease. 2008;10:6. Webster B, Corcoran A, Smaldone M, Morrisroe S, Stockton B, Jackman S, et al. Does gum chewing reduce postoperative ileus following urologic laparoscopy? A prospective randomized controlled trial. J Endourol. 2007;21(Supp 1):A137. Yang H. Influence of gum-chewing on recovery of intestinal motility after ecphyadectomy surgery in children. Journal of Nursing Science. 2011 ;26(6):23. Yazdi K, Abdollahi AA, Behnampour N, Niazi M, Arya B, Azadrah M. Effect of chewing gum on the bowel motility after cholecystectomy. Zahedan Journal of Research in Medical Sciences. 2011;13(3):20-4. Yi Y, Guo H, Xian W, Chen Y. Bile duct exploration postoperative recovery chewing gum promote peristalsis clinical observation. Laboratory Medicine and Clinic. 2013;10(10):1270-1. Zaghiyan K, Felder S, Ovsepyan G, Murrell Z, Sokol T, Moore B, Fleshner P. A prospective randomized controlled trial of sugared chewing gum on gastrointestinal recovery after major colorectal surgery in patients managed with early enteral feeding. Dis Colon Rectum. 2013 Mar;56(3):328-35. | CrossRef | PubMed |Zamora BBB, Kalalo RE. Gum chewing versus traditional feeding on the early return of bowel motility after cesarean delivery: A prospective randomized controlled trial. Int J Gynaecol Obst. 2012;119:S525. Zhang Q, Zhao P. Influence of gum chewing on return of gastrointestinal function after gastric abdominal surgery in children. Eur J Pediatr Surg. 2008 Feb;18(1):44-6. | CrossRef | PubMed |Zhao P, Zhang Q-m. The influence of chewing gum on the return of intestinal motility after abdominal surgery in children and its mechanism of action. Journal of Clinical Pediatric Surgery.2008;7(3):24-6. Zhong Z, Ye F, Lin J. study on how chewing action promotes gastrointestinal functions recovery after colorectal cancer surgery. Chinese Journal of Gastrointestinal Surgery. 2009;12(6):632-3. 
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