Clinical Trial: Does Chewing Gum After Elective Laparoscopic Colectomy Surgery Decrease Ileus?

Study Status: Terminated
Recruit Status: Terminated
Study Type: Interventional

Official Title: Does Chewing Gum After Elective Laparoscopic Colectomy Surgery Decrease Ileus?

Brief Summary:

The incidence of ileus after laparoscopic colectomy continues to pose complications for the patient, staff, and the healthcare system. Postoperative ileus remains a source of morbidity and a major determinant of length of stay after abdominal surgery. Clinicians have devised strategies that minimize postoperative ileus. Gum chewing, an inexpensive intervention, is theorized to activate the cephalic- vagal reflex and increase the production of gastrointestinal hormones associated with bowel motility. Four studies examining gum chewing as an intervention to prevent ileus were found. These relatively few studies have demonstrated inconsistencies. Because of the small sample size of the four studies and the inconsistencies of the results, there is not enough evidence to change practice. There are no indications of risks associated with gum chewing as an adjunct therapy along with standard postoperative interventions. The purpose of this prospective, randomized control study is to examine if chewing gum in adult patients after elective laparoscopic colectomy decreases ileus compared with standard post-operative care.

Patients will be randomized by weeks admitted and the patients in the gum chewing group (intervention group) will chew one stick of gum the first post-operative day, after the nasogastric tube is removed or if they patient does not have a nasogastric tube, with the head of bed elevated a minimum of 30 degrees for 30 minutes, three times a day at set intervals: 0900, 1400, and 2100. The gum will be kept in the Accudose cabinet and distributed by the medication nurse. The gum chewing regimen will continue until the first bowel movement. All patients in the non-intervention group will receive standard preoperative and postoperative regimens.

Patient demographics that will be collected include gender, age, current medi

Detailed Summary:

Postoperative ileus remains a source of morbidity and a major determinant of length of stay after abdominal surgery. This unfortunate complication may certainly affect patient's satisfaction with their postoperative course. The postoperative care of a laparoscopic colectomy patient includes interventions that are evidence-based. Despite the evidence-based interventions, the incidence of ileus after laparoscopic colectomy continues to pose complications for the patient, staff, and the healthcare system. In the time period from January 1, 2006 to November 30, 2006 there were a total of 172 laparoscopic colectomies at St. Joseph's Hospital and 28 patients developed an ileus. Six percent of colectomy patients' recovery was altered by a prolonged ileus. This is comparably and slightly less then the National Veterans Affairs Surgical Quality Improvement Program's data for postoperative ileus of 7.5 % (Longo et al. 2000). However, the length of stay for patients with an ileus was 8.4 days greater then non ileus patients, with a significant increased cost per ileus patient of $15,422.86. Clinicians have devised strategies that minimize postoperative ileus. Adjunct therapies such as motility agents, early postoperative feeding regimens, and physical therapy have been tested in clinical trials, but are not routinely used because of their limited clinical efficacy (Matros, et al. 2006). Gum chewing, an inexpensive intervention, is theorized to activate the cephalic- vagal reflex, which is usually activated by food, and to increase the production of gastrointestinal hormones associated with bowel motility (Asao, et al, 2002).

Four studies examining gum chewing as an intervention to prevent ileus were found. These relatively few studies with a sample of postoperative abdominal surgical patients have demonstrated inconsistencies. Two studies found that the chewing gum group passed flat
Sponsor: State University of New York - Upstate Medical University

Current Primary Outcome: Decrease ileus with intervention compared to standard post op care [ Time Frame: 1 year ]

Original Primary Outcome: Same as current

Current Secondary Outcome:

Original Secondary Outcome:

Information By: State University of New York - Upstate Medical University

Dates:
Date Received: March 3, 2008
Date Started: December 2007
Date Completion:
Last Updated: December 7, 2014
Last Verified: December 2014