Послеоперационный илеус в акушерско-гинекологической практике: перспективное решение проблемы

Трухан Д.И., Деговцов Е.Н., Деговцова Е.А., Карасев В.Е. Послеоперационный илеус в акушерско-гинекологической практике: перспективное решение проблемы. Гинекология. 2023;25(3):301–306.
DOI: 10.26442/20795696.2023.3.202288

© ООО «КОНСИЛИУМ МЕДИКУМ», 2023 г.

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Trukhan DI, Degovtsov EN, Degovtsova EA, Karasev VE. Postoperative ileus in obstetric and gynecological practice: a prospective solution to the problem: A review. Gynecology. 2023;25(3):301–306.
DOI: 10.26442/20795696.2023.3.202288

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Аннотация

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.

Ключевые слова: акушерство, гинекология, кесарево сечение, абдоминальная хирургия, послеоперационный парез желудочно-кишечного тракта, послеоперационный илеус, профилактика, жевательная резинка, флатус, дефекация

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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.

Keywords: obstetrics, gynecology, caesarean section, abdominal surgery, postoperative gastrointestinal paresis, postoperative ileus, prevention, chewing gum, flatus, defecation

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Список литературы

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21. Noble 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.2009.01.006
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24. Gong 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.0000000000000174
25. Abd-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.x
26. Kafali 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:10.1159/000260048
27. Shang 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-0029-1243313
28. Mohsenzadeh 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.6458
29. Jakkaew 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-x
30. Ajuzieogu 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:10.4103/1119-3077.144388
31. Akalpler 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.345.15772
32. Ahmed 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-2017-0389
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34. Ertas 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.2013.07.098
35. Jernigan 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.2014.06.008
36. Tazegül 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:10.3109/01443615.2014.970146
37. Pan 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.13664
38. Nanthiphatthanachai 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.2020.21.3.761
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41. Kadirogullari 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:10.1080/01443615.2021.1941821
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1. van 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.9691
2. 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/hirurgia2017376-85
3. Fomin VS. Postoperative dynamic intestinal obstruction: prevention and treatment. Pharmateka. 2018;7:97-101 (in Russian)].
4. 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.2018.11.159-164
5. 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.2019.6.90-96
6. Gungorduk 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.2020.11.002
7. Venara 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.2016.08.010
8. Wattchow D, Heitmann P, Smolilo D, et al. Postoperative ileus-An ongoing conundrum. Neurogastroenterol Motil. 2021;33(5):e14046. DOI:10.1111/nmo.14046
9. Harnsberger CR, Maykel JA, Alavi K. Postoperative Ileus. Clin Colon Rectal Surg. 2019;32(3):166-70. DOI:10.1055/s-0038-1677003
10. Craciunas 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:10.1111/1471-0528.12696
11. Amirian I, Gögenur I. The use of chewing gum stimulates bowel motility after gynaecological surgery. Ugeskr Laeger. 2016;178(14):V02160093.
12. Yeh YC, Klinger EV, Reddy P. Pharmacologic options to prevent postoperative ileus. Ann Pharmacother. 2009;43(9):1474-85. DOI:10.1345/aph.1M121
13. Sanfilippo F, Spoletini G. Perspectives on the importance of postoperative ileus. Curr Med Res Opin. 2015;31(4):675-6. DOI:10.1185/03007995.2015.1027184
14. Becker 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)60139-2
15. Shtoyko 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/zxab221
16. Dudi-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.15319
17. Fanning 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.2011.111.8.469
18. Li 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.12206
19. Asao 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)01179-1
20. Zhang 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-2007-989273
21. Noble 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.2009.01.006
22. Tandeter 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.2008.06.044
23. Lepore 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-2014-110058
24. Gong 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.0000000000000174
25. Abd-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.x
26. Kafali 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:10.1159/000260048
27. Shang 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-0029-1243313
28. Mohsenzadeh 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.6458
29. Jakkaew 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-x
30. Ajuzieogu 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:10.4103/1119-3077.144388
31. Akalpler 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.345.15772
32. Ahmed 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-2017-0389
33. Elkan 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.2022.03.003
34. Ertas 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.2013.07.098
35. Jernigan 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.2014.06.008
36. Tazegül 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:10.3109/01443615.2014.970146
37. Pan 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.13664
38. Nanthiphatthanachai 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.2020.21.3.761
39. Turkay 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:10.1080/01443615.2019.1652891
40. Altraigey 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:10.1080/14767058.2018.1526913
41. Kadirogullari 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:10.1080/01443615.2021.1941821
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Авторы

Д.И. Трухан*¹, Е.Н. Деговцов¹, Е.А. Деговцова², В.Е. Карасев^1,3

¹ФГБОУ ВО «Омский государственный медицинский университет» Минздрава России, Омск, Россия;
²БУ ДПО «Омский областной центр повышения квалификации работников здравоохранения», Омск, Россия;
³БУЗ ОО «Клинический онкологический диспансер», Омск, Россия
*dmitry_trukhan@mail.ru

________________________________________________

Dmitry I. Trukhan*¹, Evgeny N. Degovtsov¹, Elena A. Degovtsova², Vladimir E. Karasev^1,3

¹Omsk State Medical University, Omsk, Russia;
²Omsk Regional Center for Advanced Training of Health Workers, Omsk, Russia;
³Clinical Oncology Dispensary, Omsk, Russia
*dmitry_trukhan@mail.ru

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