ObjectiveTo investigate the effect of preoperative gum chewing on the postoperative rehabilitation of patients undergoing gynecologic laparoscopic surgery.MethodsA total of 160 patients undergoing elective gynecologic laparoscopic surgery between January and May 2013 were selected to participate in the study. Each patient was randomly assigned to one of the two groups: the trial group (n=80) or the control group (n=80). Thirty to sixty minutes before the surgery, the patients in the trial group chewed one piece of sugarless gum for at least 30 minutes, and then removed the gum before being taken to the operating room; while the patients in the control group chewed nothing. The time to first passage of flatus and the time to first defecation after surgery, length of hospital stay, the degrees of pain at 2-, 4-, 6-, 8-, 24-, 48-hour after surgery, the incidences of postoperative nausea, vomiting, and abdominal distension, postoperative analgesic and antiemetic drug requirement were recorded.ResultsThe mean time to first passage of flatus was significantly earlier in the trial group than that in the control group [(16.49±7.64) vs. (20.25±7.94) hours, P=0.003]. The mean time to first defecation was significantly earlier in the trial group than that in the control group [(48.16±15.25) vs. (55.80±18.97) hours, P=0.006]. The degree of pain at 2-hour after surgery was significantly lighter in the trial group than that in the control group (P<0.05). Fewer participants in the trial group than in the control group experienced postoperative nausea (43.75% vs. 61.25%, P=0.027). There were no significant differences in the length of hospital stay, the degrees of pain at 4-, 6-, 8-, 24- and 48-hour after surgery, incidences of postoperative vomiting and abdominal distension, postoperative analgesic, or antiemetic drug requirement between the two groups (P>0.05).ConclusionsGum chewing before surgery can promote the recovery of gastrointestinal function, reduce postoperative short-term pain, and promote postoperative rehabilitation in patients undergoing gynecologic laparoscopic surgery. Gum chewing before surgery can be used clinically as an easy, inexpensive, safe, and effective procedure.
ObjectiveTo systematically review the effect and influence of gum chewing on the recovery of gastrointestinal function in gynecological patients after operation. MethodsEBSCO, MEDLINE, Web of Science, CNKI, WanFang Data and VIP databases were electronically searched to collect randomized controlled trials of gum chewing on gastrointestinal function recovery in patients after gynecological surgery from inception to September 30th, 2020. Two reviewers independently screened literature, extracted data and assessed risk bias of included studies. RevMan 5.3 software was then used to perform the meta-analysis. ResultsA total of 9 studies were included, involving 962 patients. Meta-analysis results showed that the time of first flatus (MD=–8.34, 95%CI –10.72 to –5.95, P<0.000 01), the time of first defecation (MD=–14.97, 95%CI –29.28 to –0.66, P<0.04), and the recovery time of bowel sounds (MD=–5.83, 95%CI –10.15 to –1.51, P=0.008) of gum chewing group was significantly shorter than that of the control group, and the incidence of abdominal distension was decreased after gynecological surgery (RR=0.24, 95%CI 0.08 to 0.74, P=0.01). According to the results of subgroup analysis, the time of first flatus of the gum chewing group was significantly shorter than that of the control group in laparoscopy (MD=–5.43, 95%CI –7.12 to –3.73, P<0.000 01), laparotomy (MD=–10.46, 95%CI –13.56 to –7.97, P<0.000 01) and abdominal surgery (MD=–10.64, 95%CI –13.01 to –8.26, P<0.000 01); the first defecation time after laparotomy (MD=–29.18, 95%CI –46.03 to –12.33, P=0.000 7), and abdominal surgery (MD=–14.24, 95%CI –24.27 to –4.21, P=0.005) in chewing gum group was significantly shorter than that in the control group; however, there was no significant difference in the laparoscopy group (MD=–2.97, 95%CI –12.94 to 7.00, P=0.56). ConclusionsThe systematic review and meta-analysis shows that gum chewing after gynecological surgery can shorten the time of first flatus, first defecation, and first bowel movement, and reduce the incidence of abdominal distension. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusions.