Meta-Analysis of the Effect of Gum Chewing After Gynecologic Surgery

Abstract

Objective: To describe the scientific evidence related to gum chewing to reduce ileus after gynecologic surgery.

Data sources: A literature search was performed using Ovid Medline, Embase, Cochrane Library, CINAHL, Scopus, and Web of Science databases.

Study selection: Inclusion criteria included randomized controlled trials (RCTs) on the use of gum chewing after gynecologic surgery in which the main outcomes measured were time to first flatus, time to defecation, and length of hospital stay.

Data extraction: Data on authors, country, randomization method, the type of disease, surgical and anesthetic methods, sample characteristics such as age and body mass index, gum chewing program, and study results were extracted from selected articles.

Data synthesis: Of 493 publications, eight RCTs conducted between 2013 and 2017 involving 1,077 women were included in our meta-analysis. Weighted mean differences (WMDs) with 95% confidence intervals were calculated for the eight studies with the use of Cochrane Review Manager Version 5.3 (RevMan; 2014). The pooled results showed that gum chewing was superior to no gum chewing, with a reduction in WMD for time to first flatus of -6.20 hours (95% confidence interval [CI] [-9.51, -2.88]), WMD for time to first defecation of -9.03 hours (95% CI [-14.02, -4.04]), and WMD for length of hospital stay of -0.36 days (95% CI [-0.72, -0.01]).

Conclusion: Gum chewing significantly reduced the time to first flatus and defecation after gynecologic surgery and should be recommended by health care providers.

Keywords: chewing gum; defecation; flatulence; gynecologic surgery; meta-analysis; postoperative ileus.