Chewing Gum After Radical Cystectomy With Urinary Diversion for Recovery of Intestinal Function: A Systematic Review and Meta-Analysis

Purpose To evaluate the efficacy of chewing in the recovery of intestinal function after radical cystectomy. Design Systematic review and meta-analysis. Methods Following the PRISMA statement, PubMed, CINAHL, Google Scholar, Cochrane Review Database, EMBASE, Scopus, and grey literature were searched for evidence. Findings The analysis included 2 trials with 100 patients. Compared to placebo, chewing gum resulted in faster recovery of bowel function (mean difference [MD], -16.00; 95% confidence interval [CI], -18.67 to -13.32; P < .00001). In addition, chewing gum decreased the time to flatus (MD, -14.81; 95% CI, -22.14 to -7.47; P < .0001), but did not reduced the length of stay (MD, 0.97; 95% CI, -1.23 to 3.18; P = .39) and the incidence of postoperative ileus (risk ratio, 0.67; 95% CI, 0.20-2.23; P = .51). The quality of evidence is low due to imprecision and suspected publication bias. Conclusions Chewing gum appears to be an inexpensive intervention to improve the return of bowel function in patients undergoing radical cystectomy.