Evidence map›Paper›PMID 28660314›Full record

Trial reportInternational journal of colorectal disease2017

Nicotine chewing gum for the prevention of postoperative ileus after colorectal surgery: a multicenter, double-blind, randomised, controlled pilot study.

Daniël P V Lambrichts, Geesien S A Boersema, Buket Tas, Zhouqiao Wu, Wietske W Vrijland, Gert-Jan Kleinrensink, Johannes Jeekel, Johan F Lange, Anand G Menon

Open access · hybridAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in International journal of colorectal disease, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
2.5field-weighted citation impact, top 11% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Review
  4. Review
  5. Article
  6. Review
  7. Observational
  8. Risk factors for ileus after hip and knee arthroplasty.International journal of colorectal disease · 2019
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 2 countries.

Daniël P V LambrichtsDepartment of Surgery, Erasmus University Medical Center, Room H822k, PO BOX 2040, 3000 CA, Rotterdam, The Netherlands. d.lambrichts@erasmusmc.nl.
Geesien S A BoersemaDepartment of Surgery, Erasmus University Medical Center, Room H822k, PO BOX 2040, 3000 CA, Rotterdam, The Netherlands.
Buket TasDepartment of Surgery, Erasmus University Medical Center, Room H822k, PO BOX 2040, 3000 CA, Rotterdam, The Netherlands.
Zhouqiao WuKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education, Beijing), Ward I of Gastrointestinal Cancer Center, Peking University Cancer Hospital & Institute, Beijing, China.
Wietske W VrijlandDepartment of Surgery, Franciscus Gasthuis & Vlietland, Rotterdam, The Netherlands.
Gert-Jan KleinrensinkDepartment of Neuroscience, Erasmus University Medical Center, Rotterdam, The Netherlands.
Johannes JeekelDepartment of Neuroscience, Erasmus University Medical Center, Rotterdam, The Netherlands.
Johan F LangeDepartment of Surgery, Erasmus University Medical Center, Room H822k, PO BOX 2040, 3000 CA, Rotterdam, The Netherlands.
Anand G MenonDepartment of Surgery, Erasmus University Medical Center, Room H822k, PO BOX 2040, 3000 CA, Rotterdam, The Netherlands.
Erasmus MC · NLHavenziekenhuis Rotterdam · NLPeking University Cancer Hospital · CNSint Franciscus Gasthuis · NL

Funding

Stichting Coolsingel 191
6 · The paper itself

Abstract

purposeWhen postoperative ileus is not resolved after 5 days or recurs after resolution, prolonged POI (PPOI) is diagnosed. PPOI increases discomfort, morbidity and hospitalisation length, and is mainly caused by an inflammatory response following intestinal manipulation. This response can be weakened by targeting the cholinergic anti-inflammatory pathway, with nicotine as essential regulator. Chewing gum, already known to stimulate gastrointestinal motility itself, combined with nicotine is hypothesised to improve gastrointestinal recovery and prevent PPOI. This pilot study is the first to assess efficacy and safety of nicotine gum in colorectal surgery.

methodsPatients undergoing elective oncological colorectal surgery were enrolled in this double-blind, parallel-group, controlled trial and randomly assigned to a treatment protocol with normal or nicotine gum (2 mg). Patient reported outcomes (PROMS), clinical characteristics and blood samples were collected. Primary endpoint was defined as time to first passage of faeces and toleration of solid food for at least 24 h.

resultsIn total, 40 patients were enrolled (20 vs. 20). In both groups, six patients developed PPOI. Time to primary endpoint (4.50 [3.00-7.25] vs. 3.50 days [3.00-4.25], p = 0.398) and length of stay (5.50 [4.00-8.50] vs. 4.50 days [4.00-6.00], p = 0.738) did not differ significantly between normal and nicotine gum. There were no differences in PROMS, inflammatory parameters and postoperative complications.

conclusionsWe proved nicotine gum to be safe but ineffective in improving gastrointestinal recovery and prevention of PPOI after colorectal surgery. Other dosages and administration routes of nicotine should be tested in future research.

Indexed as

Nicotine Chewing GumAdministration, OralAgedColonDefecationDigestive System Surgical ProceduresDouble-Blind MethodFemaleGastrointestinal MotilityHumansIleusLength of StayMaleMiddle AgedNetherlandsNicotineNicotineNicotine Chewing GumNicotinic AgonistsColorectal surgeryNicotine chewing gumPostoperative ileusPrevention

Identifiers

PMID28660314
PMCPMC5554272
OpenAlexW2727365230

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

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.