Dissertations / Theses on the topic 'Postoperative ileus'

Sammanfattning Bakgrund: Postoperativ ileus är en allvarlig komplikation som kan uppstå, ofta till följd av smärtstillande läkemedel eller inflammation i tarmvävnaden. Tarmmotoriken avstannar och gas- och tarmavgång upphör. Symtomen är kraftiga buksmärtor, kräkningar och utspänd buk. Patienten utsätts för smärta, oro och förlängd sjukhusvistelse. Syfte: Att beskriva omvårdnadsåtgärder sjuksköterskan kan vidta för att förebygga postoperativ ileus samt att beskriva urvalsgrupperna i de inkluderade artiklarna. Metod: En litteraturstudie av deskriptiv design som grundas på elva vetenskapliga artiklar, samtliga med kvantitativ ansats. Huvudresultat: Omvårdnadsåtgärder som tidigt oralt vätske- och födointag, tugga tuggummi, mobilisering, gunga gungstol, akupressur och sjuksköterskeledd information har visats påskynda läkning av tarmen och reducera risken av postoperativ ileus. Omvårdnadsåtgärderna visade bäst resultat gällande tarmljud, tarmrörelser, gas- och tarmavgång och tolerans av normal föda. Slutsats: Omvårdnadsåtgärder har visats ha god effekt vid förebyggande av postoperativ ileus. Tydliga tecken på att tarmen återhämtat sig och att den postoperativa tarmparalysen upphört är gas- och tarmavgång, tarmljud och tarmrörelser, vilket samtliga påskyndas av omvårdnadsåtgärder. Att kontinuerligt ta del av kunskap genom forskning möjliggör för sjuksköterskan att utföra professionell omvårdnad av hög standard. Det är sjuksköterskans ansvar att utföra omvårdnadsåtgärder som förebygger risker, minskar lidande och främjar hälsa.
Abstract Background: Postoperative ileus is a serious complication, often due to pain relief medication or the inflammation of intestinal tissue. Bowel movements stop and the gastrointestinal tract ceases and the resulting symptoms are: severe abdominal pain, vomiting and tensioned abdomen. This result in pain, anxiety and long-term hospitalization for the patient. Aim: To describe nursing interventions which prevent postoperative ileus and describe the selection groups of included articles. Method: A literature study of descriptive design based on eleven articles, all of which take a quantitative approach. Main result: Nursing interventions such as; early oral fluid and food intake, chewing gum, mobilization, swing rocking chair, acupressure and nurse information have been shown to accelerate healing of the intestine and reduce the risk of postoperative ileus. Nursing interventions had best result relating to: bowel sound, bowel movement, defecation and tolerance of normal food. Conclusion: Nursing interventions have been shown effective in the prevention of postoperative ileus. Clear indications of intestinal recovery and postoperative paralysis recovery include first flatus, bowel sound, bowel movement and defecation, all of which are more likely to occur if the patient has had nursing intervention. Continuously acquiring knowledge through research enables nurses to perform professional care of high standard. It is the nurse's responsibility to carry out nursing interventions that prevent risks, reduce suffering and promote healing.

Bakgrund: Efter kirurgiska ingrepp förekommer postoperativt ileus (POI) som ett normalfysiologiskt tillstånd. POI definieras som ett avvikande mönster av gastrointestinal motilitet med karakteristiska symtom som illamående och kräkningar, uppspänd buk, samt utebliven gasavgång eller avföring. POI har påvisats påverka den postoperativa återhämtningen negativt. Syfte: Syftet med studien var att kartlägga interventioner som används för att minska durationen av postoperativt ileus vid svenska kirurgiska vårdavdelningar. Design: Enkätbaserad tvärsnittsstudie. Metod: Internetbaserad enkät skickades till vårdenhetschefer vid 86 kirurgiskt inriktade vårdavdelningar på fem universitetssjukhus i södra och mellersta Sverige. Resultat: Totalt 21 kirurgiska vårdavdelningar besvarade enkäten. Kunskaper kring innebörden och handläggningen av POI angavs som måttliga till goda. Den mest frekvent föreslagna interventionen inom omvårdnad var mobilisering och laxantia i olika former var den vanligaste farmakologiska interventionen. Konklusion: Omvårdnads- och farmakologiska interventioner av varierande evidensgrad används på svenska kirurgiska vårdavdelningar. Det tycks finnas ett behov av utbildning om och implementering av vetenskapliga kunskaper inom området för bedömning och handläggning av POI.
Background: Postoperative ileus (POI) occurs as a normal reaction to all forms of surgery. POI is defined as a deviant pattern of gastrointestinal motility with characteristic symptoms such as nausea and vomiting, abdominal distension and lack of gas or stool. Postoperative ileus has been shown to affect the postoperative recovery in a negative way. Aim: The aim of this study was to investigate the current use of interventions aimed to reduce the duration time of postoperative ileus in Swedish surgical wards. Design: A cross-sectional study. Method: A web-based survey was administered to matrons at 86 surgical wards in five university hospitals in the mid- and south of Sweden. Results: In total, 21 wards responded. The knowledge about the meaning and management of POI was perceived as moderate to good. The most frequent used nursing intervention was mobilization, and the most common pharmacological action proposed was laxatives of various sorts. Conclusion: Both nursing and pharmacological interventions with various grades of evidence are used in Swedish surgical wards. There are indications of a need for education and implementation of science-based knowledge within the area of assessing and managing POI.

Dysfunktion av den gastrointestinala motiliteten under det postoperativa skedet är en komplikation som kan orsakas till följd av kirurgiska ingrepp. Detta kan orsaka bukspänning, illamående samt smärta som komplicerar en ofullständig och snabb återhämtning efter kirurgiska ingrepp. Dysfunktion av den gastrointestinala motiliteten ökar risken för ytterligare postoperativa komplikationer som uttorkning, elektrolytrubbning och sepsis. Samt ökar riskerna för reoperation och återintagning på sjukhus efter utskrivning. Dysfunktion av den gastrointestinala motiliteten kan ge ökat lidande för patienter, skapa längre vårdtider, medföra högre sjukhuskostnader samt öka arbetsbelastningen för hälso- och sjukvårdspersonal. Syfte: Syftet var att beskriva sjuksköterskors omvårdnadsåtgärder vid dysfunktion av den gastrointestinala motiliteten hos patienter under det postoperativa skedet. Metod: Studien genomfördes som en allmän litteraturstudie med induktiv ansats. Resultat: Resultatet baserades på nio vetenskapliga artiklar med kvantitativa ansats. Utifrån kodning av meningsenheter från de vetenskapliga artiklarna framkom fyra huvudkategorier: Patientnära samtal, Mobilisering, Kost- och vätskeintag och Stimulering av den gastrointestinala motiliteten. Slutsats: Omvårdnadsåtgärder var en viktig del i förebyggandet för främjandet av den gastrointestinala motiliteten under det postoperativa skedet samt förbättrade möjligheten till ett tidigare tillfrisknande för patienter. Ett tidigt ingripande med omvårdnadsåtgärder till patienter som genomgått kirurgi bidrog det till minskat lidande, kortare vårdtider för patienterna samt minskad arbetsbelastning för hälso- och sjukvårdspersonal.
Dysfunction of the gastrointestinal motility in the post-operative stage is a complication that can be caused by surgical procedures. This can cause abdominal tension, nausea and pain that complicate an incomplete and rapid recovery after surgery. Dysfunction of gastrointestinal motility increases the risk of additional postoperative complications such as dehydration, electrolyte disruption and sepsis. As well as increasing the risk of reoperation and readmission in hospitals after discharge. Dysfunction of the gastrointestinal motility can lead to increased suffering for patients, create longer care times, bring higher hospital costs and increase the workload of healthcare professionals. Purpose: The purpose was to describe nursing care measures in dysfunction of the gastrointestinal motility to patients in the postoperative stage. Method: The study was conducted as a literature review with inductive approach. Result: The result was based on nine scientific articles with quantitative approaches. Based on the coding of opinion units from the scientific articles, four main categories emerged: Patient-related conversation, Mobilization, Diet and fluid intake and Stimulation of gastrointestinal motility. Conclusion: Nursing care measures were an important part of the prevention of the promotion of gastrointestinal motility in the postoperative stage, and improved the possibility of an earlier recovery for patients. Early intervention with nursing care measures for patients who have undergone surgery, it contributed to reduced suffering, shorter patient care times and reduced workload for healthcare professionals.

Abdominal surgery inhibits gastrointestinal motility, a phenomenon referred to as postoperative ileus. Since the postoperative ileus disturbs duodenal physiology it is important to minimize the side effects of this condition. Recent experiments in our laboratory show that treatment of anaesthetised rats with parecoxib, a selective cyclooxygenase-2 inhibitor, prevents duodenal postoperative ileus, increases duodenal mucosal bicarbonate secretion and improves other functions as well. One aim of the thesis was to investigate whether removal of luminal chloride affect the parecoxib- and the vasoactive intestinal peptide (VIP)-induced stimulation of duodenal mucosal bicarbonate secretion. The proximal duodenum of anaesthetised Dark Agouti rats was perfused with isotonic solutions containing zero or low Cl- and the effect on luminal alkalinisation determined. The basal as well as the parecoxib-induced increase in alkalinisation, but not that stimulated by VIP, were markedly reduced in the absence of luminal Cl-. One important function of the duodenum is to adjust luminal osmolality towards that in the blood. It is believed that the adjustment of osmolality in the duodenum is achieved by osmosis and diffusion of electrolytes along their concentration gradients and that these processes occur predominately paracellularly. Another aim of the thesis was to examine whether prevention of postoperative ileus affects the duodenal response to luminal hypertonicity. The proximal duodenum of anaesthetised Dark Agouti and Sprague-Dawley rats were perfused with hypertonic solutions of different composition and osmolality and the effects on duodenal motility, alkaline secretion, transepithelial fluid flux, mucosal permeability and the adjustment of luminal osmolality were determined in absence and presence of parecoxib. It is concluded that COX-2 inhibition increases duodenal mucosal bicarbonate secretion by stimulating apical Cl-/HCO3- exchange in duodenocytes. Furthermore, pretreatment of anaesthetised rats with parecoxib improves a number of duodenal functions in both rat strains that contribute to improve the ability to adjust luminal osmolality. The choice of rat strain is another important feature to consider when interpreting the results because the DA strain was more responsive to luminal hypertonicity than the SD strain. Finally, several evidences are provided to suggest that the adjustment of luminal osmolality in the rat duodenum is a regulated process.

Отримані результати дають лише загальну уяву про РПСНК, але дозволяють зробити висновки про те, що це захворювання призводить до глибоких порушень гомеостазу на фоні виснаження захисних сил організму. Виникають пневмонії, причиною яких є застій і аспірація внаслідок тривалого ліжкового режиму і трансназальної інтубації тонкої кишки. Гнійно- запальні процеси у післяопераційній рані та черевній порожнині виникають внаслідок порушень гомеостазу і склеювання петель кишечника.

El íleo postoperatorio (IPO) se define como el cese temporal de la motilidad propulsiva gastrointestinal (GI) en pacientes sometidos a cirugía intestinal. En pacientes y en modelos experimentales de IPO, se ha observado degranulación de mastocitos (MCs) en lavado peritoneal. Estudios con fármacos estabilizadores de MCs o en modelos en roedores carentes de mastocitos apoyan la participación de los MCs en el IPO. No obstante, los mecanismos involucrados aún están por definir. La interacción nervio-mastocito, así como la interacción con el factor de crecimiento nervioso (NGF), podrían representar un factor clave en el desarrollo del IPO. El objetivo del presente trabajo ha sido estudiar el IPO humano caracterizando la activación de los mastocitos peritoneales (PMCs) durante la cirugía colorectal. A parte, también nos propusimos explorar el papel del NGF sobre los MCs y la interacción nervio-mastocito en un modelo experimental de IPO en rata. Primero se estudió el IPO humano. Evaluamos la liberación de proteasas mastocitarias (mediante la técnica de ELISA) en el lavado peritoneal de pacientes sometidos a cirugía colorectal por laparoscopia y laparotomía, así como también la densidad de MCs (por inmunohistoquímica) y la recuperación clínica postoperatoria. Seguidamente se puso a punto un modelo de IPO en rata para profundizar en el papel de los MCs. En él, evaluamos el efecto del antagonista del receptor del NGF, K252a. Previamente habíamos demostrado el efecto in vitro del K252a sobre PMCs. Asimismo, hemos evaluado la participación de los ganglios de la raíz dorsal (DRG) en el IPO además de evaluar las consecuencias funcionales de la activación mastocitaria en animales tratados con el estabilizador de mastocitos ketotifeno o mediante la exposición del intestino al degranulador de mastocitos compuesto 48/80. Los resultados de este trabajo demuestran que la cirugía colorectal induce la liberación de proteasas mastocitarias en la cavidad peritoneal en aquellos pacientes que desarrollaron un IPO. En la rata, inmediatamente tras la inducción del modelo, se produjo un aumento en la liberación de la proteasa mastocitaria RMCP-6 (inmunoensayo) en la cavidad peritoneal. A las 24h, se observó un retraso en el tránsito GI y un aumento en la expresión de la interleuquina-6 (IL-6, RT-qPCR) y en la actividad mieloperoxidasa (MPO) en las muestras de íleon. El K252a inhibió la degranulación in vitro de los PMCs (valorada mediante el ensayo de la β-hexosaminidasa) así como también atenuó la liberación de RMCP-6 y la expresión génica tanto de IL-6, como de RMCP-2 y TrkA (receptor del NGF) en el modelo. Sin embargo, no mejoró la motilidad GI. Por otro lado, la expresión de mediadores calcitonin gene-related peptide (CGRP), NGF, TrkA and protease-activated receptor-2 en los DRGs aumentó tras la inducción del modelo. Estos cambios no se vieron afectados tras el tratamiento con ketotifeno o la exposición a C48/80. En cambio, el C48/80 si produjo un retraso en el vaciamiento gástrico/tránsito intestinal así como también aumentó la expresión de IL-6 y actividad MPO. El uso de ketotifeno, previno el retraso en el vaciamiento gástrico y la disminución post-operatoria del output fecal. Este trabajo nos permite concluir que los MCs participan en el IPO y que la interacción entre el NGF, TrkA y PMCs puede representar una diana para el tratamiento del IPO u otras alteraciones mediadas por mastocitos.
Postoperative ileus (POI) is defined as a temporal cessation of propulsive gastrointestinal (GI) motility in patients undergoing abdominal surgery, especially those subjected to intestinal resection. Mast cell (MC) degranulation has been reported in patients undergoing abdominal surgery and in experimental models of POI. MC stabilizers or the use of MC-deficient mutant models point towards a role for MCs in POI, but the exact mechanisms involved remains unclear. Interactions between MCs and nerve endings or inflammatory mediators such as the nerve growth factor (NGF) may represent a key factor in POI pathogenesis. The aim of this work was to study POI in human patients by characterizing the activation of peritoneal mast cells (PMCs) in colorectal surgery. A part from that, we also aimed to explore the role of NGF antagonists on MCs and MC-nerve interactions in a rat model of POI. We firstly studied human POI. We evaluated MC protease release in peritoneal lavage (by means of ELISA) collected from patients undergoing laparoscopic and open colorectal surgery. In these patients we also studied MC density in colonic samples (by immunohistochemistry) and postoperative clinical recovery. Secondly, we set up a model of POI in rat to further explore the role of MCs. We evaluated the effect of pre-treatment with NGF receptor antagonist, K252a. In vitro effects of K252a were also evaluated on rat PMCs. Activation of dorsal root ganglia (DRG) in POI rat model was also characterized in a separate experiment in which the role of MCs was investigated using ketotifen (MC stabilizer) and compound 48/80 (C48/80, MC degranulator). Our study demonstrated release of MC proteases into peritoneal cavity after colorectal surgery. This protease release was observed only in patients with a subsequent delay of clinical recovery (those who developed POI). In our animal study we demonstrated that induction of POI by intestinal manipulation immediately evokes release of MC protease RMCP-6 in the peritoneal cavity. At 24h after intestinal manipulation, our model also presented delayed GI transit and increased expression of interleukin-6 (IL-6, RT-qPCR) and myeloperoxidase activity (MPO) in ileum samples. In contrast, density of intestinal MCs (immunohistochemistry and toluidine blue staining) and RMCP-2 and 6 gene expressions (RT-qPCR) in the ileum were unaltered in the animal POI model. K252a prevented PMC degranulation in vitro (β-hexosaminidase assay) and the release of RMCP-6 in the POI model. In addition, K252a attenuated IL-6 expression after intestinal manipulation and decreased basal peritoneal release of RMCP-2 and TrkA (NGF receptor) gene expression However, GI transit was not ameliorated after K252a treatment. Intestinal manipulation in the POI model also increased gene expression of calcitonin gene-related peptide, NGF, TrkA and protease-activated receptor-2 in somas of DRGs but these changes were not modulated by ketotifen or C48/80. In contrast, C48/80 did delay GI transit and induced up-regulation of IL-6 and MPO activity. Ketotifen also prevented delayed gastric emptying and the postoperative decrease of fecal output. To sum up, our results indicate that intestinal manipulation is associated with a local response of MCs in the peritoneal cavity. Intestinal manipulation delayed GI motility in vivo, induced intestinal inflammation and activated DRGs. K252a stabilized MCs and down-regulated IL-6 expression in the inflammatory response leading to POI. Our data also showed that MCs are involved in GI motility alteration and inflammation after intestinal manipulation. In contrast, activation of DRGs seems to be independent of MC activation based on our assessment using a pharmacological approach. We conclude that MCs participate in POI and that interactions between NGF, TrkA and PMCs may represent a target for treatment of POI or other MC-mediated diseases.

Patienter som genomgått en operation kan drabbas av komplikationer. Postoperativ ileus kan leda till fördröjd återhämtning, ytterligare komplikationer samt ett ökat obehag för den enskilde patienten. Det leder även till ökade kostnader för samhället och förlängd sjukhusvistelse. Sjuksköterskor är ett viktigt stöd i den postoperativa omvårdnaden och kan med omvårdnadsåtgärder stödja patienter. Syftet med denna integrerade litteraturöversikt var att sammanställa kunskap gällande omvårdnadsåtgärder sjuksköterskor kan tillämpa för att förebygga eller lindra postoperativ ileus. Litteratursökning utfördes i PubMed och CINAHL med sökord som definierades utifrån syftet. Kvalitetsgranskning utfördes och 18 artiklar ingick sedan i analysen. I resultatet framkom att ett strukturerat arbetssätt, utifrån relevanta bedömningar med tidigt insättande av omvårdnadsåtgärder som kontinuerligt utfördes utifrån en helhetsbild av patientens situation var fördelaktig för att undvika och lindra postoperativ ileus. Enskilda åtgärder som tidig mobilisering, tidig enteralnutrition, att tugga tuggummi samt undvikande av nasogastrisk sond kunde tillämpas, men mest fördelaktigt var fast tracking där flera omvårdnadsåtgärder tillämpades samtidigt. Det tillkommer ständigt ny forskning som behöver granskas och utvärderas. Relevanta och effektiva omvårdnadsåtgärder tas fram och som sedan måste tillämpas i den kliniska verksamheten.

Postoperative ileus (POI) is characterised by impairment of bowel motility leading to a delayed return of gastrointestinal (GI) function. It is a common complication after major abdominal surgery, and its clinical features include nausea, vomiting, abdominal distension, and delayed passage of flatus and stool. It predisposes patients to malnutrition, wound failure, and pneumonia, and often requires invasive interventions that significantly impact patient recovery and experience. The occurrence of POI is one of the most important determinants of adverse patient outcome after surgery, often surpassing both preoperative comorbid risk profile and intraoperative factors in the magnitude of its effect on short and long term survival. Delayed return of GI function as a single complication has the largest overall impact on healthcare costs. We do not have cost figures for Australia, but the estimated annual cost in the United States of this complication is approximately $1.5 billion. POI or delayed return of gastro-intestinal function is not a normal or routine part of recovery after abdominal surgery. It arises in around 10-30% of patients and is increasingly regarded as a potentially preventable or treatable problem, the management of which is currently suboptimal. Most published and in-press research on this topic is almost exclusively focused on novel therapeutic medications to treat and prevent ileus. While some of these medications, such as Alvimopan and Prucalopride, may be promising in this regard, they tend to be quite expensive and currently not funded (nor approved) for use in Australia for this indication. There is a major knowledge gap, and significant variability, in the use of readily available “off the shelf” medications and techniques to improve the return of normal GI function. In particular, the use of simple laxatives has been largely overlooked and not subjected to scientific testing despite sporadic worldwide use. This thesis aims to examine the available evidence for laxative use in this clinical setting, document usage patterns in routine clinical practice, and establish their clinical effectiveness and safety profile. A five-step process was adopted to answer these questions. Firstly, a systematic scoping review of Enhanced Recovery After Surgery (ERAS) protocols used in colorectal surgery worldwide was conducted. Second, a systematic review of randomised trials evaluating the safety and efficacy of laxative use after major abdominal surgery was conducted. Third, a global survey to gauge surgeons’ preferences and practice regarding laxative use was undertaken to understand the reasons behind the varied uptake rates of these medications in routine clinical practice. Fourth, a retrospective cohort study was conducted in the colorectal unit at the Royal Adelaide Hospital (RAH), to document the safety and efficacy profile of laxative use in these patients. Finally, an open label randomised controlled trial (RCT) of the combination of simple stimulant and osmotic laxatives to reduce the duration of postoperative Ileus (POI) in patient’s undergoing colorectal surgery (STIMULAX trial) was conducted. Our research found that ERAS protocols commonly recommended laxatives as an intervention targeting POI and return of GI function, but the type and dose were inconsistent, and the evidence quoted was limited. The systematic review of RCT data revealed that while laxative use may result in an earlier passage of a stool after major abdominal surgery, it did not influence other postoperative recovery parameters. There was insufficient data to evaluate the safety profile of laxatives in this setting. Furthermore, this lack of high-quality evidence appeared to be the main reason why most surgeons do not routinely prescribe laxatives after elective colorectal surgery, as shown by the global survey we conducted. This survey also showed that there is wide variability in the type of laxatives used amongst those surgeons who do use laxatives. We then conducted an RCT on the risk-benefit of laxative use after elective colorectal surgery (STIMIULAX trial) to address the knowledge gap. The trial showed that patients receiving multimodal laxatives achieved earlier recovery of GI function after surgery, compared with a control group. There was no difference in major complications, length of stay, or any other key recovery parameters. This paved the way for our final Phase II study (PyRiCo-P). We investigated whether we could safely circumvent the autonomic dysfunction caused after surgery by administering oral Pyridostigmine to reduce the duration of postoperative Ileus after colorectal surgery. Fifteen patients were recruited, and none of the patients had any adverse events. We suggest the next step is to conduct a double-blinded randomised controlled trial to assess the efficacy of Pyridostigmine in this setting. This thesis contributes new evidence on therapeutic effectiveness of laxatives to reduce the duration of ileus after major abdominal surgery and has established a baseline framework upon which future trials of novel medications can be assessed.
Thesis (Ph.D.) -- University of Adelaide, Adelaide Medical School, 2021

碩士
長榮大學
護理學系碩士班
104
Colorectal cancer is the first most common cancer in Taiwan and the surgical resection is currently the first choice to carry out the treatment on the disease. However, each patient who receives such surgery has to experience temporary disturbance in gastric and bowel motility and needs time of recovery flatus pass after surgery; this recovery period is also refered to postoperative ileus. The longer the postoperative ileus is, the more length of hospital stay will be, which will also increase medical costs. The aim of study was to explore the effectiveness of chewing gum on recovery from postoperative ileus after colorectal resection. An experimental and prospective single blinded study was conducted in a medical center and a regional teaching hospital in Southern Taiwan. Data were collected in gastrointestinal surgical wards. There were a total of 30 participants in a gum-chewing group and 30 patients in a control group participating in the study after written informed consent. Participants who were (1) aged 40-75 years old and diagnosed with colorectal cancer on stage I, II, or III and scheduled for open colorectal resection with only one bowel anastomosis; (2) conscious clear and able to communicate in either Chinese or Taiwanese; and (3) no nasogastric tube placed after surgery were recruited. Exclusion criteria included (1) the score of Karnofsky Scale on neither zero nor one; (2) receiving emergent surgery; (3) evidence showed intra-abdominal infection before operation by finding of abdomianl CT; (4) having a loop colostomy after surgery; (5) having an ileostomy after surgery; (6) experience of previous pelvic radiation therapy; and (7) jaw joint and chewing muscle dysfunction. Participants who agreed and provided written informed consent were assigned to either experimental group or control group. A total of 60 participants, 30 participants in each group, finished the study. The questionnaires included the Karnofsky Scale, the demographic characteristics of the colorectal resection patients, the surgery-related survey, and the bowel function survey. Participants experimental group received sugar-free chewing gum contains xylitol. The gum-chewing group was scheduled to chew gum for 15 minutes from the first postoperative day and 3 times a day (i.e. 9:00AM, 2:00PM and 7:00PM) and each of them had to carry out the chewing until his or her first flatus. The control group received routine postoperative care. All subjects in this study were calculated from their first pass flatus and first defecation. Data were analyzed using the SPSS 20.0 statistical software. Statistical methods included chi-square test, Fisher's exact test, independent t-test, Mann-Whitney U test, Spearman’s rank correlation coeffient, and ANCOVA analysis. Results showed that the first passage of flatus occurred on postoperative hour 39.13±15.66 in the gum-chewing group and on hour 52.92±21.97 in the control group (p = .004). The first defecation occurred on postoperative hour 54.55±18.90 in the gum-chewing group and on hour 77.98±34.59 in the control group (p = .025). There was significantly positive correlation that the first passage of flatus and the first defecation in both experimental group (rs＝0.376; p＝.02) and the control group (rs＝0.533; p＝.001). After adjusting operative time and ages, ANCOVA reveals that the first passage of flatus in the gum-chewing group was faster than control group ( p＝.008), without affecting the first defecation (p＝.073). In this study, no severe complications or side effects were caused by gum chewing in any patients. Based on the findings of this study, gum chewing, which is highly recommended to extend the experience to clinical application, is a safe and cheap intervention to reduce postoperative ileus after colorectal resection.