Authors (including presenting author) :
Chung KS, Lau WM
Affiliation :
Perioperative Surgery Nurse Clinic, Department of Surgery, Tseung Kwan O Hospital
Keyword 1: :
Colorectal surgery
Introduction :
Colorectal cancer is one of the most common cancers in Hong Kong, with over 5,000 new cases newly diagnosed each year (Hong Kong Cancer Registry). While surgery is the standard treatment for localized colorectal cancer, however, postoperative ileus frequently occurs after lower gastrointestinal surgery. Research has shown that ileus develops in about 25% of gastrointestinal surgeries (Chapuis, 2013). Postoperative ileus not only impacts the patient’s nutritional status and prolongs hospital stay but is also linked to various surgical complications, including aspiration and anastomotic leakage. Chewing gum is a safe and effective intervention to promote early recovery of gastrointestinal function. It can stimulate gastrointestinal motility by activating the cephalic-gastro-colic reflex, which increases gastric emptying and gut movement, thereby helping to shorten the duration of postoperative ileus. According to a study, chewing gum practice enhanced the time of first flatus from 34 (7-144 hours, n=41) hours to 18 hours (5-90 hours, n=41) (P=0.007). (Shum, 2016)
Objectives :
To investigate whether the chewing gum practice in elective colorectal surgery can promote post operative gastrointestinal function and reduce the occurrence of ileus incident.
Methodology :
Surgical Outcome Monitoring & Improvement Program (SOMIP) report will be used to compare the post operative ileus incidents in elective colorectal surgery before and after initiating chewing gum practice in local population.
Result & Outcome :
According to the SOMIP report 13/14, the year before the ERAS program and chewing gum practice was introduced at TKOH, the postoperative ileus rate for elective lower GI surgery was 5.4%, which was higher than the HA benchmark of 4.4%. After the ERAS program was launched in 2015, chewing gum during the early postoperative period became a common practice in elective lower GI surgeries at TKOH. Comparing this to the latest data from SOMIP 23/24, the postoperative ileus rate has decreased to 3.4%, which is lower than the HA benchmark of 7.7%. Chewing gum practice served as a safe and effective practice to reduce post operative ileus incident. It is a safe and effective method to promote early recovery of gastrointestinal function in local population.
