Chewing Gum Has a Stimulatory Effect on Bowel Motility in Patients After Open or Robotic Radical Cystectomy for Bladder Cancer: A Prospective Randomized Comparative Study

Abstract

To determine whether chewing gum during the postoperative period facilitates the recovery of bowel function and has different efficacy according to operative method used in patients with radical cystectomy. From July 2007 to September 2009, we randomized open radical cystectomy (ORC) patients into Group AI (ORC without gum chewing) and Group AII (ORC with gum chewing). Robot-assisted radical cystectomy (RARC) patients were randomized into Group BI (RARC without gum chewing) and Group BII (RARC with gum chewing). A total of 32 ORC (17 Group AI and 15 Group AII) and 28 RARC (13 Group BI and 15 Group BII) patients were completed. The patient's perioperative data between the control (AI + BI) and chewing gum (AII + BII) group showed no differences. The median time to flatus and to bowel movement were significantly reduced in chewing gum group compared with the control patients: 57.1 vs. 69.5 hours 76.7 vs. 93.3 hours. In the ORC patients, decrease in time to flatus and bowel movement were observed in gum chewing (AII) group than control (AI) group: 64.3 vs. 80.3 hours 83.8 vs. 104.2 hours. In RARC patients, decrease in time to flatus and bowel movement were found in gum chewing (BII) group than control (BI) group: 48.8 vs. 60.3 hours 69.1 vs. 84.6 hours. No adverse effects were observed with chewing gum. Chewing gum had stimulatory effects on bowel motility after cystectomy and urinary diversion. Chewing gum was safe and could be used for postoperative ileus regardless of the operative method (ORC or RARC).