the 2 groups. All gum-chewing patients completed their
course of gum chewing until bowel function. All gumchewing
patients tolerated the gum. Mobilization for all
patients began on the first postoperative day. The first
feelings of hunger were felt on postoperative hour 63.5
in the gum-chewing group and on hour 72.8 in the control
group (P=.27). The first passage of flatus was seen
on postoperative hour 65.4 in the gum-chewing group
and on hour 80.2 in the control group (P=.05). The first
bowel movement was on postoperative hour 63.2 in the
gum-chewing group and on hour 89.4 in the control group
(P=.04).
There were no surgical complications in either group.
Minor complications occurred in 3 patients. Two patients
(one in each group) experienced rapid atrial fibrillation
controlled with medications and diuresis. One patient
in the control group experienced postoperative ileus
and required nasogastric tube decompression for 2 days
with resolution. No patient in either group required admission
in the perioperative period defined as the 1-month
follow-up. The total length of hospital stay was shorter
in the gum-chewing group (day 4.3) than in the control
group (day 6.8) (P=.01), (Table 3).
COMMENT
Postoperative hospital stays after elective sigmoid colon
resections are reported as lasting between 4 to 12 days.2
Lengthy hospital stays increase costs and may be associated
with an increased risk of nosocomial complications.
One factor that often contributes to prolonged hospital
stay after colectomy is paralytic ileus. The etiology
of postoperative ileus remains controversial. Bowel motility
is suppressed postoperatively owing to sympathetic
hyperactivity and increased concentrations of circulating
catecholamines.6 Pacemaker dysfunction owing
to bowel manipulation is another postulated mecha-