Chewing Gum After Radical Cystectomy With Urinary Diversion for Recovery of Intestinal Function: A Systematic Review and Meta-Analysis

Purpose: To evaluate the efficacy of chewing in the recovery of intestinal function after radical cystectomy. Design: Systematic review and meta-analysis. Methods: Following the PRISMA statement, PubMed, CINAHL, Google Scholar, Cochrane Review Database, EMBASE, Scopus, and grey literature were searched for evidence. Findings: The analysis included 2 trials with 100 patients. Compared to placebo, chewing gum resulted in faster recovery of bowel function (mean difference [MD], -16.00; 95% confidence interval [CI], -18.67 to -13.32; P <.00001). In addition, chewing gum decreased the time to flatus (MD, -14.81; 95% CI, -22.14 to -7.47; P <.0001), but did not reduced the length of stay (MD, 0.97; 95% CI, -1.23 to 3.18; P =.39) and the incidence of postoperative ileus (risk ratio, 0.67; 95% CI, 0.20-2.23; P =.51). The quality of evidence is low due to imprecision and suspected publication bias. Conclusions: Chewing gum appears to be an inexpensive intervention to improve the return of bowel function in patients undergoing radical cystectomy.(c) 2021 American Society of PeriAnesthesia Nurses.