Evidence map›Paper›PMID 27146793›Full record

Trial reportThe British journal of surgery2016

Randomized clinical trial of postoperative chewing gum versus standard care after colorectal resection.

C Atkinson, C M Penfold, A R Ness, R J Longman, S J Thomas, W Hollingworth, R Kandiyali, S D Leary, S J Lewis

2 registry-linked trialsOpen access · bronzeAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in The British journal of surgery, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 22 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed, 7 pooled it
7.5field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02813278 phase3completednot on this map

Efficacy of Simo Decoction and Acupuncture or Chewing Gum Alone on Postoperative Ileus in Colorectal Cancer Resection: a Randomized Clinical Trial

TypeinterventionalSponsorGuangxi Medical UniversityRan2014 to 2016Enrolled600ConditionsColorectal CancerArmssimo decoction, gum chewing
NCT04489875 naunknown statusnot on this mapstarted 2020, after this paper: background citation

Gum Chewing Reduces the Risk of Postoperative Ileus After Arthroplasty Procedures in The Elderly Population: A Parallel Design, Open-Label, Randomized Controlled Trial

TypeinterventionalSponsorIndus Hospital and Health NetworkRan2020 to 2021Enrolled50ConditionsParalytic IleusArmsChewing Gum
3 · Its place in the literature

Who cites it

22 citing papers in PubMed, 7 syntheses or guidelines pooled it, 52 citations in OpenAlex.

  1. Pooled it
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  5. The Impact of Sham Feeding with Chewing Gum on Postoperative Ileus Following Colorectal Surgery: a Meta-Analysis of Randomised Controlled Trials.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2020
    Pooled it
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  8. Trial
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  11. Article
  12. Review
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  19. Perioperative Factors Predicting Prolonged Postoperative Ileus After Major Abdominal Surgery.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2018
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 5 institutions in 1 country.

C AtkinsonSchools of Oral and Dental Sciences, University of Bristol, Bristol, UK.
C M PenfoldSchools of Oral and Dental Sciences, University of Bristol, Bristol, UK.
A R NessSchools of Oral and Dental Sciences, University of Bristol, Bristol, UK.
R J LongmanDepartment of Coloproctology, University Hospitals Bristol NHS Foundation Trust, Bristol, UK.
S J ThomasSchools of Oral and Dental Sciences, University of Bristol, Bristol, UK.
W HollingworthSchools of Social and Community Medicine, University of Bristol, Bristol, UK.
R KandiyaliSchools of Social and Community Medicine, University of Bristol, Bristol, UK.
S D LearySchools of Oral and Dental Sciences, University of Bristol, Bristol, UK.
S J LewisNational Institute for Health Research Biomedical Research Unit in Nutrition, Diet and Lifestyle, University Hospitals Bristol Education Centre, Bristol, UK.
University Of Bristol Dental Hospital · GBNIHR Bristol Biomedical Research Centre · GBUniversity of Bristol · GBNational Institute for Health Research · GBUniversity Hospitals Bristol NHS Foundation Trust · GB

Funding

Department of Health PB-PG-0807-14113
6 · The paper itself

Abstract

backgroundChewing gum may stimulate gastrointestinal motility, with beneficial effects on postoperative ileus suggested in small studies. The primary aim of this trial was to determine whether chewing gum reduces length of hospital stay (LOS) after colorectal resection. Secondary aims included examining bowel habit symptoms, complications and healthcare costs.

methodsThis clinical trial allocated patients randomly to standard postoperative care with or without chewing gum (sugar-free gum for at least 10 min, four times per day on days 1-5) in five UK hospitals. The primary outcome was LOS. Cox regression was used to calculate hazard ratios for LOS.

resultsData from 402 of 412 patients, of whom 199 (49·5 per cent) were allocated to chewing gum, were available for analysis. Some 40 per cent of patients in both groups had laparoscopic surgery, and all study sites used enhanced recovery programmes. Median (i.q.r.) LOS was 7 (5-11) days in both groups (P = 0·962); the hazard ratio for use of gum was 0·94 (95 per cent c.i. 0·77 to 1·15; P = 0·557). Participants allocated to gum had worse quality of life, measured using the EuroQoL 5D-3L, than controls at 6 and 12 weeks after operation (but not on day 4). They also had more complications graded III or above according to the Dindo-Demartines-Clavien classification (16 versus 6 in the group that received standard care) and deaths (11 versus 0), but none was classed as related to gum. No other differences were observed.

conclusionChewing gum did not alter the return of bowel function or LOS after colorectal resection. REGISTRATION NUMBER: ISRCTN55784442 (http://www.controlled-trials.com).

Indexed as

Chewing GumColectomyPostoperative CareAgedDefecationFemaleFlatulenceGastrointestinal MotilityHumansIleusLength of StayMalePostoperative ComplicationsQuality of LifeSingle-Blind MethodUnited KingdomChewing Gum

Identifiers

PMID27146793
PMCPMC5084762
OpenAlexW2345897009

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.