Abstarct
Background: Postoperative bowel ileus is a common consequence of abdominal surgery. Gum chewing has been reported to reduce postoperative ileus. Up to date, no study investigated the effect of gum chewing on ileus after elective abdominal gynecologic surgery was reported.
Objective: To compare the additional use of gum chewing with standard postoperative management in Thai gynecological patients undergoing abdominal surgery.
Study design: Randomized control trial
Material and Methods: A total of 128 patients were recruited in this study. Eligible patients were randomly assigned to one of two groups; group A received standard postoperative care and group B received gum chewing with standard postoperative care. Each patient was asked to complete a questionnaire on demographic data. Data about diagnosis, operation, anesthetic method, blood loss, analgesic drugs, and antiflatulance were obtained from operative note, anesthetic note, and medical records.
Results: The first passage of blenching and flatus was noted postoperatively at hour 14.7 and 16.1 in group B, and 19.2 and 19.9 in group A, respectively. Patients in group B had significantly higher number of blenching, flatus, and bowel sound than those in group A in every time point assessment, except the number of flatus in postoperative day 3 that was not significantly different. Patients in group A had significantly higher abdominal distention score than those in group B in every time point assessment. Increasing waist circumference is significantly higher in group A than group B in postoperative day 2 and 3. Patients in group A had significantly more severity of ileus than those in group B in postoperative day 1-3. Patients in group B had higher satisfaction and overall satisfaction score than those in group A.
Conclusion: Gum chewing provides a simple method for early recovery from postoperative ileus. Patients can tolerate gum chewing as early as the first operative day. It is a physiological method for stimulating bowel motility. Gum chewing should be added as an adjunctive treatment in postoperative care in gynecologic surgery.