ObjectiveTo assess the effect of chewing gum on the recovery of postoperative gastrointestinal function in patients with colorectal cancer. MethodsA comprehensive search for relevant randomised controlled trials (RCTs) was conducted in domestic and international databases such as PubMed, The Cochrane Library, Web of Science, Chinese Science and Technology Journal Full-text Database, Chinese Periodicals Full-text Database, Wanfang data, and other databases, with a timeframe up to September 2023. The literature was screened according to the inclusion and exclusion criteria. Simultaneously, the literature quality evaluation and data extraction were performed. The continuous variables were described using mean difference (95% confidence interval) and the binary variables were described using odds ratio (95% confidence interval). Test level was α=0.05. ResultsA total of 28 RCTs covering 2 523 postoperative colorectal cancer patients were included. The meta-analysis results showed that the postoperative chewing gum could shorten the time of the first flatus [–11.99 (–14.45, –9.53)], the first defecation [–18.79 (–23.58, –14.00)], the first bowel sounds [–6.35 (–6.64, –6.06)] or the first starvation [–5.20 (–10.11, –0.28)], and the hospital stay [–1.35 (–1.99, –0.70)], as well as could increase the serum gastrin level [23.70 (14.88, 32.53)]. Furthermore, it also could decrease the incidence of postoperative complications, such as nausea [0.66 (0.48, 0.91)], abdominal distension [0.48 (0.35, 0.67)], and intestinal obstruction [0.34 (0.20, 0.59)]. However, there was a non-significant effect on vomiting [0.81 (0.60, 1.09)] or time of the first oral intake [–0.67 (–1.99, 0.65)]. ConclusionsFrom the results of this meta-analysis, postoperative gum chewing aids to promote the recovery of gastrointestinal function and reduce the risk of postoperative complications in colorectal cancer patients. Although further studies are needed to verify the long-term effects and the feasibility of clinical application, the results of this study provide an important empirical support for the utilize of chewing gum in the management of postoperative gastrointestinal function.
ObjectiveTo explore the risk factors for failure of enhanced recovery after surgery (ERAS) in partial hepatectomy. MethodsA retrospective analysis was performed on 344 patients who underwent partial hepatectomy at the Division of Liver Surgery, Department of General Surgery in West China Hospital of Sichuan University from January 2019 to December 2019. All patients were treated with ERAS after partial hepatectomy. Univariate and multivariate logistic regression analysis were used to evaluate the risk factors associated with failure of the ERAS after partial hepatectomy. ResultsA total of 344 patients were included in the study, including 44 patients in the ERAS failure group and 300 patients in the ERAS success group. Multivariate logistic regression showed that combined with chronic diseases [OR=2.32, 95%CI (1.07, 4.93), P=0.03] and intraoperative fluid replacement volume ≤2 475 mL [OR=2.16, 95%CI (1.06, 4.42), P=0.03] were risk factors for failure of ERAS. ConclusionChronic diseases and intraoperative fluid volume ≤2 475 mL are risk factors for the failure of ERAS after partial hepatectomy and can affect prognosis.