GynecologyGynecologyГинекология2079-56962079-5831Consilium Medicum25313010.26442/20795696.2023.3.202288REVIEWОБЗОРReview ArticlePostoperative ileus in obstetric and gynecological practice: a prospective solution to the problem: A reviewПослеоперационный илеус в акушерско-гинекологической практике: перспективное решение проблемыhttps://orcid.org/0000-0002-1597-18762414-6938TrukhanDmitry I.ТруханДмитрий Иванович
Russian Federation

D. Sci. (Med.), Assoc. Prof., Omsk State Medical University

доктор медицинских наук, доц., профессор, каф. поликлинической терапии и внутренних болезней ФГБОУ ВО ОмГМУ

dmitry_trukhan@mail.ruhttps://orcid.org/0000-0003-0385-82328566-7424DegovtsovEvgeny N.ДеговцовЕвгений Николаевич
Russian Federation

D. Sci. (Med.), Omsk State Medical University

доктор медицинских наук, зав. каф. госпитальной хирургии ФГБОУ ВО ОмГМУ

edego2001@mail.ruDegovtsovaElena А.ДеговцоваЕлена Алексеевна
Russian Federation

Obstetrics and Gynecology Teacher, Omsk Regional Center for Advanced Training of Health Workers

преподаватель акушерства и гинекологии БУ ДПО ОО ЦПК РЗ

dmitry_trukhan@mail.ruhttps://orcid.org/0000-0002-6134-87192081-4205KarasevVladimir E.КарасевВладимир Евгеньевич
Russian Federation

Cand. Sci. (Med.), Omsk State Medical University, Clinical Oncology Dispensary

кандидат медицинских наук, доц. каф. онкологии, лучевой терапии дополнительного профессионального образования ФГБОУ ВО ОмГМУ, зав. хирургическим отделением №3 БУЗ ОО КОД

osmaoncology@gmail.comOmsk State Medical UniversityФГБОУ ВО «Омский государственный медицинский университет» Минздрава РоссииOmsk Regional Center for Advanced Training of Health WorkersБУ ДПО «Омский областной центр повышения квалификации работников здравоохранения»Clinical Oncology DispensaryБУЗ ОО «Клинический онкологический диспансер»041020232533013072002202315092023Copyright ©; 2023, Consilium MedicumCopyright ©; 2023, ООО "Консилиум Медикум"2023Consilium MedicumООО "Консилиум Медикум"https://creativecommons.org/licenses/by-nc-sa/4.0https://gynecology.orscience.ru/2079-5831/article/view/253130

In obstetric and gynecological practice, after operations on the abdominal cavity, the development of dynamic intestinal obstruction, which is referred to as postoperative ileus, is possible. The frequency of POI after gynecological surgery averages 10–15% (range 5–25%). Chewing gum has been used in abdominal surgery and obstetric and gynecological practice to reduce postoperative intestinal obstruction since the beginning of the 21st century. The present review considers the main randomized clinical trials, reviews and meta-analyses devoted to the study of the effect of chewing gum after surgical interventions in obstetric and gynecological practice for the prevention of postoperative ileus. The data presented in the review indicate the effectiveness and safety of the use of chewing gum in the postoperative period for the prevention of postoperative ileus in obstetric and gynecological practice.

В акушерско-гинекологической практике после операций на брюшной полости возможно развитие динамической кишечной непроходимости, которая обозначается как послеоперационный илеус (ПОИ). Частота ПОИ после гинекологической операции составляет в среднем 10–15% (в диапазоне 5–25%). Жевательная резинка используется в абдоминальной хирургии и акушерско-гинекологической практике для уменьшения послеоперационной кишечной непроходимости с начала XXI в. В рамках представленного обзора рассмотрены основные рандомизированные клинические исследования, обзоры и метаанализы, посвященные изучению эффекта жевательной резинки после хирургических вмешательств в акушерско-гинекологической практике для профилактики ПОИ. Приведенные в обзоре данные свидетельствуют об эффективности и безопасности применения жевательной резинки в послеоперационном периоде для профилактики ПОИ в данной практике.

obstetricsgynecologycaesarean sectionabdominal surgerypostoperative gastrointestinal paresispostoperative ileuspreventionchewing gumflatusdefecationакушерствогинекологиякесарево сечениеабдоминальная хирургияпослеоперационный парез желудочно-кишечного трактапослеоперационный илеуспрофилактикажевательная резинкафлатусдефекацияvan den Heijkant TC, Costes LM, van der Lee DG, et al. Randomized clinical trial of the effect of gum chewing on postoperative ileus and inflammation in colorectal surgery. Br J Surg. 2015;102(3):202-11. DOI:10.1002/bjs.9691Хомяков Е.А., Рыбаков Е.Г. Послеоперационный парез желудочно-кишечного тракта. Хирургия. Журнал имени Н.И. Пирогова. 2017;3:76-85 [Khomyakov EA, Rybakov EG. Postoperative paresis of the gastrointestinal tract. Pirogov Russian Journal of Surgery = Khirurgiya. Zurnal im. N.I. Pirogova. 2017;3:76-85 (in Russian)]. DOI:10.17116/hirurgia2017376-85Фомин В.С. Послеоперационная динамическая кишечная непроходимость: профилактика и лечение. Фарматека. 2018;7:97-101 [Fomin VS. Postoperative dynamic intestinal obstruction: prevention and treatment. Pharmateka. 2018;7:97-101 (in Russian)].Упрямова Е.Ю., Новикова С.В., Цивцивадзе Е.Б. Послеоперационный парез кишечника в акушерско-гинекологической практике. Акушерство и гинекология. 2018;11:159-64 [Upryamova EYu, Novikova SV, Tsivtsivadze EB. Postoperative intestinal paresis in obstetric and gynecological practice. Obstetrics and gynecology. 2018;11:159-64 (in Russian)]. DOI:10.18565/aig.2018.11.159-164Фомин В.С., Луценко В.Д., Овешникова Т.З., Фомина М.Н. Современное состояние вопроса профилактики и лечения послеоперационного пареза кишечника в акушерской практике. Фарматека. 2019;6:84-9 [Fomin VS, Lutsenko VD, Oveshnikova TZ, Fomina MN. The current state of the issue of prevention and treatment of postoperative intestinal paresis in obstetric practice. Pharmateka. 2019;6:84-9 (in Russian)]. DOI:10.18565/pharmateca.2019.6.90-96Gungorduk K, Ozdemir IA. Non-pharmacological interventions for the prevention of postoperative ileus after gynecologic cancer surgery. Taiwan J Obstet Gynecol. 2021;60(1):9-12. DOI:10.1016/j.tjog.2020.11.002Venara A, Neunlist M, Slim K, et al. Postoperative ileus: Pathophysiology, incidence, and prevention. J Visc Surg. 2016;153(6):439-46. DOI:10.1016/j.jviscsurg.2016.08.010Wattchow D, Heitmann P, Smolilo D, et al. Postoperative ileus-An ongoing conundrum. Neurogastroenterol Motil. 2021;33(5):e14046. DOI:10.1111/nmo.14046Harnsberger CR, Maykel JA, Alavi K. Postoperative Ileus. Clin Colon Rectal Surg. 2019;32(3):166-70. DOI:10.1055/s-0038-1677003Craciunas L, Sajid MS, Ahmed AS. Chewing gum in preventing postoperative ileus in women undergoing caesarean section: a systematic review and meta-analysis of randomised controlled trials. BJOG. 2014;121(7):793-9; discussion 799. DOI:10.1111/1471-0528.12696Amirian I, Gögenur I. The use of chewing gum stimulates bowel motility after gynaecological surgery. Ugeskr Laeger. 2016;178(14):V02160093.Yeh YC, Klinger EV, Reddy P. Pharmacologic options to prevent postoperative ileus. Ann Pharmacother. 2009;43(9):1474-85. DOI:10.1345/aph.1M121Sanfilippo F, Spoletini G. Perspectives on the importance of postoperative ileus. Curr Med Res Opin. 2015;31(4):675-6. DOI:10.1185/03007995.2015.1027184Becker G, Blum HE. Novel opioid antagonists for opioid-induced bowel dysfunction and postoperative ileus. Lancet. 2009;373(9670):1198-206. DOI:10.1016/S0140-6736(09)60139-2Shtoyko AN, Cwikla GM, Feldman EA, et al. Trust your gut: Effect of a pharmacist-driven pilot project to decrease alvimopan use past gastrointestinal recovery in postsurgical patients. Am J Health Syst Pharm. 2021:zxab221. DOI:10.1093/ajhp/zxab221Dudi-Venkata NN, Kroon HM, Bedrikovetski S, et al. Systematic scoping review of enhanced recovery protocol recommendations targeting return of gastrointestinal function after colorectal surgery. ANZ J Surg. 2020;90(1-2):41-7. DOI:10.1111/ans.15319Fanning J, Hojat R. Safety and efficacy of immediate postoperative feeding and bowel stimulation to prevent ileus after major gynecologic surgical procedures. J Am Osteopath Assoc. 2011;111(8):469-72. DOI:10.7556/jaoa.2011.111.8.469Li S, Liu Y, Peng Q, et al. Chewing gum reduces postoperative ileus following abdominal surgery: a meta-analysis of 17 randomized controlled trials. J Gastroenterol Hepatol. 2013;28(7):1122-32. DOI:10.1111/jgh.12206Asao T, Kuwano H, Nakamura J, et al. Gum chewing enhances early recovery from postoperative ileus after laparoscopic colectomy. J Am Coll Surg. 2002;195(1):30-2. DOI:10.1016/s1072-7515(02)01179-1Zhang Q, Zhao P. Influence of gum chewing on return of gastrointestinal function after gastric abdominal surgery in children. Eur J Pediatr Surg. 2008;18(1):44-6. DOI:10.1055/s-2007-989273Noble EJ, Harris R, Hosie KB, et al. Gum chewing reduces postoperative ileus? A systematic review and meta-analysis. Int J Surg. 2009;7(2):100-5. DOI:10.1016/j.ijsu.2009.01.006Tandeter H. Hypothesis: hexitols in chewing gum may play a role in reducing postoperative ileus. Med Hypotheses. 2009;72(1):39-40. DOI:10.1016/j.mehy.2008.06.044Lepore M, Fitzgerald JE. Gum chewing is associated with early recovery of bowel motility and shorter length of hospital stay for women after caesarean section. Evid Based Med. 2015;20(1):22. DOI:10.1136/ebmed-2014-110058Gong Y, Zhang Q, Qiao L, et al. Xylitol Gum Chewing to Achieve Early Postoperative Restoration of Bowel Motility After Laparoscopic Surgery. Surg Laparosc Endosc Percutan Tech. 2015;25(4):303-6. DOI:10.1097/SLE.0000000000000174Abd-El-Maeboud KH, Ibrahim MI, Shalaby DA, Fikry MF. Gum chewing stimulates early return of bowel motility after caesarean section. BJOG. 2009;116(10):1334-9. DOI:10.1111/j.1471-0528.2009.02225.xKafali H, Duvan CI, Gözdemir E, et al. Influence of gum chewing on postoperative bowel activity after cesarean section. Gynecol Obstet Invest. 2010;69(2):84-7. DOI:10.1159/000260048Shang H, Yang Y, Tong X, et al. Gum chewing slightly enhances early recovery from postoperative ileus after cesarean section: results of a prospective, randomized, controlled trial. Am J Perinatol. 2010;27(5):387-91. DOI:10.1055/s-0029-1243313Mohsenzadeh Ledari F, Barat S, Delavar MA, et al. Chewing sugar-free gum reduces ileus after cesarean section in nulliparous women: a randomized clinical trial. Iran Red Crescent Med J. 2013;15(4):330-4. DOI:10.5812/ircmj.6458Jakkaew B, Charoenkwan K. Effects of gum chewing on recovery of bowel function following cesarean section: a randomized controlled trial. Arch Gynecol Obstet. 2013;288(2):255-60. DOI:10.1007/s00404-013-2727-xAjuzieogu OV, Amucheazi A, Ezike HA, et al. The efficacy of chewing gum on postoperative ileus following cesarean section in Enugu, South East Nigeria: A randomized controlled clinical trial. Niger J Clin Pract. 2014;17(6):739-42. DOI:10.4103/1119-3077.144388Akalpler O, Okumus H. Gum chewing and bowel function after Caesarean section under spinal anesthesia. Pak J Med Sci. 2018;34(5):1242-7. DOI:10.12669/pjms.345.15772Ahmed MR, Sayed Ahmed WA, Khamess RE, et al. Efficacy of three different regimens in recovery of bowel function following elective cesarean section: a randomized trial. J Perinat Med. 2018;46(7):786-90. DOI:10.1515/jpm-2017-0389Elkan Kiyat Z, Kahyaoglu Sut H. The Effect of Xylitol Gum Chewing After Cesarean on Bowel Functions: A Randomized Controlled Study. J Perianesth Nurs. 2022;37(6):913-7. DOI:10.1016/j.jopan.2022.03.003Ertas IE, Gungorduk K, Ozdemir A, et al. Influence of gum chewing on postoperative bowel activity after complete staging surgery for gynecological malignancies: a randomized controlled trial. Gynecol Oncol. 2013;131(1):118-22. DOI:10.1016/j.ygyno.2013.07.098Jernigan AM, Chen CC, Sewell C. A randomized trial of chewing gum to prevent postoperative ileus after laparotomy for benign gynecologic surgery. Int J Gynaecol Obstet. 2014;127(3):279-82. DOI:10.1016/j.ijgo.2014.06.008Tazegül Pekin A, Kerimoğlu OS, Doğan NU, et al. Gum chewing reduces the time to first defaecation after pelvic surgery: A randomised controlled study. J Obstet Gynaecol. 2015;35(5):494-8. DOI:10.3109/01443615.2014.970146Pan Y, Chen L, Zhong X, Feng S. Gum chewing combined with oral intake of a semi-liquid diet in the postoperative care of patients after gynaecologic laparoscopic surgery. J Clin Nurs. 2017;26(19-20):3156-63. DOI:10.1111/jocn.13664Nanthiphatthanachai A, Insin P. Effect of Chewing Gum on Gastrointestinal Function Recovery After Surgery of Gynecological Cancer Patients at Rajavithi Hospital: A Randomized Controlled Trial. Asian Pac J Cancer Prev. 2020;21(3):761-70. DOI:10.31557/APJCP.2020.21.3.761Turkay Ü, Yavuz A, Hortu İ, et al. The impact of chewing gum on postoperative bowel activity and postoperative pain after total laparoscopic hysterectomy. J Obstet Gynaecol. 2020;40(5):705-9. DOI:10.1080/01443615.2019.1652891Altraigey A, Ellaithy M, Atia H, et al. The effect of gum chewing on the return of bowel motility after planned cesarean delivery: a randomized controlled trial. J Matern Fetal Neonatal Med. 2020;33(10):1670-7. DOI:10.1080/14767058.2018.1526913Kadirogullari P, Seckin KD, Yalcin Bahat P, Aytufan Z. The effect of chewing gum on bowel function postoperatively in patients with total laparoscopic hysterectomy: a randomised controlled trial. J Obstet Gynaecol. 2022;42(5):1192-7. DOI:10.1080/01443615.2021.1941821Zhu YP, Wang WJ, Zhang SL, et al. Effects of gum chewing on postoperative bowel motility after caesarean section: a meta-analysis of randomised controlled trials. BJOG. 2014;121(7):787-92. DOI:10.1111/1471-0528.12662Huang H-P, He M. Usefulness of chewing gum for recovering intestinal function after cesarean delivery: A systematic review and meta-analysis of randomized controlled trials. Taiwan J Obstet Gynecol. 2015;54(2):116-21. DOI:10.1016/j.tjog.2014.10.004Hochner H, Tenfelde SM, Abu Ahmad W, Liebergall-Wischnitzer M. Gum chewing and gastrointestinal function following caesarean delivery: a systematic review and meta-analysis. J Clin Nurs. 2015;24(13-14):1795-804. DOI:10.1111/jocn.12836