Effect of Smoked Plum and Chewing Gum on Postoperative Bowel Function Following Hepatic Resection
Effect of Smoked Plum and Chewing Gum on Postoperative Bowel Function Following Hepatic Resection
Every patient undergoing surgery in the abdomen, such as hepatic resection, will experience
 temporary paralysis of bowel function. This study aims to evaluate whether smoked plum and
 chewing gum can reduce the bowel paralysis after hepatic resection in patients with
 hepatocellular carcinoma. One third of the study population will receive smoked plum, one
 third with chewing gum, and the last will act as empty control.
Hepatectomy is widely used to treat patients with hepatocellular carcinoma (HCC), even those
 with intermediate and advanced disease. Despite its well-demonstrated clinical safety and
 efficacy in many patients, it is associated with postoperative morbidity and mortality. One
 complication after hepatectomy is delayed resumption of gastrointestinal function, known as
 postoperative ileus. This can decrease patient comfort and increase morbidity and mortality,
 prolonging hospital stay and raising healthcare costs. While postoperative ileus usually
 resolves within approximately 3 days, it can last longer in some cases as a condition termed
 postoperative paralytic ileus. Postoperative use of opioid-based analgesics can increase
 incidence of postoperative ileus.

 No drugs or interventions to prevent or treat postoperative ileus have been approved by the
 China Drug Administration or the US Food and Drug Administration. Several studies show that
 chewing gum, a new and simple modality, can accelerate complication-free recovery of
 gastrointestinal function following gastrointestinal surgery and obstetrical-gynecological
 surgery. This raises the question whether postoperative smoked plum, or chewing gum can
 reduce risk of postoperative ileus following hepatectomy. To examine this question, we
 conducted a randomized controlled trial to compare incidence of postoperative ileus and
 length of hospital stay in HCC patients who received smoked plum, chewing gum or no
 intervention following hepatectomy.
Inclusion Criteria:

 -  Underwent open hepatic resection

 -  Diagnosis of HCC was confirmed by histopathological examination of surgical samples in
 all patients

 Exclusion Criteria:

 -  Previously underwent exploratory laparotomy

 -  Laparoscopic surgery

 -  Known Central Nervous System tumors including metastatic brain disease

 -  History of organ allograft

 -  Substance abuse, medical, psychological or social conditions that may interfere with
 the patient's participation in the study or evaluation of the study results

 -  Any condition that is unstable or which could jeopardize the safety of the patient and
 his/her compliance in the study

 -  Pregnant or breast-feeding patients