Randomized controlled trials (RCTs) that compared gum chewing with a control treatment for the amelioration of postoperative ileus in patients after colorectal surgery were eligible for inclusion. The review outcomes were time to flatus, time to defaecation, and overall hospital stay.
Most of the included trials performed the open colectomies; one trial performed laparoscopic colectomies. All included trials administered gum chewing three times daily. Three trials used thoracic epidural analgesia for patients. It appeared that the control treatment in included trials was usual care; one trial used an acupressure bracelet as an additional sham control. The mean age of participants ranged from 54 to 68 years; most were male. Forty percent of trials included resections for benign or malignant disease; the remaining trials included resections for malignant disease only. Included trials were conducted in Japan, USA and the UK.
Three reviewers independently assessed studies for inclusion, with any disagreement resolved by discussion.