Effect of chewing gum on gastrointestinal function after colorectal cancer surgery:a meta-analysis
Objective To assess the effect of chewing gum on the recovery of postoperative gastrointestinal function in patients with colorectal cancer.Methods A comprehensive search for relevant randomised controlled trials(RCTs)was conducted in domestic and international databases such as PubMed,The Cochrane Library,Web of Science,Chinese Science and Technology Journal Full-text Database,Chinese Periodicals Full-text Database,Wanfang data,and other databases,with a timeframe up to September 2023.The literature was screened according to the inclusion and exclusion criteria.Simultaneously,the literature quality evaluation and data extraction were performed.The continuous variables were described using mean difference(95%confidence interval)and the binary variables were described using odds ratio(95%confidence interval).Test level was α=0.05.Results A total of 28 RCTs covering 2 523 postoperative colorectal cancer patients were included.The meta-analysis results showed that the postoperative chewing gum could shorten the time of the first flatus[-11.99(-14.45,-9.53)],the first defecation[-18.79(-23.58,-14.00)],the first bowel sounds[-6.35(-6.64,-6.06)]or the first starvation[-5.20(-10.11,-0.28)],and the hospital stay[-1.35(-1.99,-0.70)],as well as could increase the serum gastrin level[23.70(14.88,32.53)].Furthermore,it also could decrease the incidence of postoperative complications,such as nausea[0.66(0.48,0.91)],abdominal distension[0.48(0.35,0.67)],and intestinal obstruction[0.34(0.20,0.59)].However,there was a non-significant effect on vomiting[0.81(0.60,1.09)]or time of the first oral intake[-0.67(-1.99,0.65)].Conclusions From the results of this meta-analysis,postoperative gum chewing aids to promote the recovery of gastrointestinal function and reduce the risk of postoperative complications in colorectal cancer patients.Although further studies are needed to verify the long-term effects and the feasibility of clinical application,the results of this study provide an important empirical support for the utilize of chewing gum in the management of postoperative gastrointestinal function.