1
|
Lirk P, Badaoui J, Stuempflen M, Hedayat M, Freys SM, Joshi GP. PROcedure-SPECific postoperative pain management guideline for laparoscopic colorectal surgery: A systematic review with recommendations for postoperative pain management. Eur J Anaesthesiol 2024; 41:161-173. [PMID: 38298101 DOI: 10.1097/eja.0000000000001945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2024]
Abstract
Colorectal cancer is the second most common cancer diagnosed in women and third most common in men. Laparoscopic resection has become the standard surgical technique worldwide given its notable benefits, mainly the shorter length of stay and less postoperative pain. The aim of this systematic review was to evaluate the current literature on postoperative pain management following laparoscopic colorectal surgery and update previous procedure-specific pain management recommendations. The primary outcomes were postoperative pain scores and opioid requirements. We also considered study quality, clinical relevance of trial design, and a comprehensive risk-benefit assessment of the analgesic intervention. We performed a literature search to identify randomised controlled studies (RCTs) published before January 2022. Seventy-two studies were included in the present analysis. Through the established PROSPECT process, we recommend basic analgesia (paracetamol for rectal surgery, and paracetamol with either a nonsteroidal anti-inflammatory drug or cyclo-oxygenase-2-specific inhibitor for colonic surgery) and wound infiltration as first-line interventions. No consensus could be achieved either for the use of intrathecal morphine or intravenous lidocaine; no recommendation can be made for these interventions. However, intravenous lidocaine may be considered when basic analgesia cannot be provided.
Collapse
Affiliation(s)
- Philipp Lirk
- From the Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital (PL, JB, MS), Department of Anesthesiology, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA (MH), Department of Surgery, DIAKO Ev. Diakonie-Krankenhaus, Bremen, Germany (SMF) and Department of Anesthesiology, UT Southwestern Medical Center, Dallas, Texas, USA (GPJ)
| | | | | | | | | | | |
Collapse
|
2
|
Patton ME, Andrews FM, Bogers SH, Wong D, McKenzie HC, Werre SR, Byron CR. Effects of Bit Chewing on Gastric Emptying, Small Intestinal Transit, and Orocecal Transit Times in Clinically Normal Horses. Animals (Basel) 2023; 13:2518. [PMID: 37570326 PMCID: PMC10416828 DOI: 10.3390/ani13152518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 07/26/2023] [Accepted: 08/02/2023] [Indexed: 08/13/2023] Open
Abstract
Ileus is a common life-threatening problem in horses, and currently available treatments may be ineffective. The purpose of this study was to determine whether bit chewing, a form of sham feeding, decreases the gastric emptying time (GET), small intestinal transit time (SITT), and total orocecal transit time (OCTT) in clinically normal horses in a prospective crossover study. Nine healthy horses were acclimated and fed a standardized diet. Following 24 h of fasting, self-contained video endoscopy capsules and acetaminophen were administered into the stomach via a nasogastric tube. Each horse underwent experimental (bit chewing for 20 min every 6 h) or control (no bit chewing) conditions, with a 3-week minimum washout period between conditions. The horses were enrolled in either part of the study until all video capsules were retrieved and/or 30 days lapsed. The video capsules were recovered from manure, and GET, SITT, and OCTT were determined from a video analysis. Bit chewing significantly decreased OCTT (p = 0.015) compared to the control conditions. Bit chewing decreased GET and SITT, but the differences were not significant. The mean (median) times determined via the video capsule analysis for the bit-chewing conditions were as follows: GET, 2.34 h (2.86 h); SITT, 3.22 h (3.65 h); and OCTT, 5.13 h (6.15 h), and for the control conditions, they were as follows: GET, 3.93 h (5 h); SITT, 3.79 h (4.4 h); and OCTT, 8.02 h (9.92 h). Bit chewing decreased OCTT in healthy horses. Because this segment of the gastrointestinal tract is frequently affected by ileus, bit chewing may be a safe and inexpensive intervention for that condition in horses. Further investigation in clinical patients with ileus is warranted.
Collapse
Affiliation(s)
- Molly E. Patton
- Department of Large Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, 205 Duck Pond Drive, Blacksburg, VA 24061, USA; (M.E.P.); (S.H.B.); (H.C.M.III)
| | - Frank M. Andrews
- Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA 70803, USA;
| | - Sophie H. Bogers
- Department of Large Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, 205 Duck Pond Drive, Blacksburg, VA 24061, USA; (M.E.P.); (S.H.B.); (H.C.M.III)
| | - David Wong
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, 1800 Christensen Drive, Ames, IW 50011, USA;
| | - Harold C. McKenzie
- Department of Large Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, 205 Duck Pond Drive, Blacksburg, VA 24061, USA; (M.E.P.); (S.H.B.); (H.C.M.III)
| | - Stephen R. Werre
- Laboratory for Study Design and Statistical Analysis, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, 205 Duck Pond Drive, Blacksburg, VA 24061, USA;
| | - Christopher R. Byron
- Department of Large Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, 205 Duck Pond Drive, Blacksburg, VA 24061, USA; (M.E.P.); (S.H.B.); (H.C.M.III)
| |
Collapse
|
3
|
ERAS: An Audit of Existing Practices. J Obstet Gynaecol India 2022; 72:243-249. [DOI: 10.1007/s13224-021-01517-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 06/09/2021] [Indexed: 11/26/2022] Open
|
4
|
Iavazzo C, Gkegkes ID, Vrachnis N. Chewing gum in the enhanced recovery protocols of patients undergoing total laparoscopic hysterectomy. J OBSTET GYNAECOL 2022; 42:1606. [PMID: 35166188 DOI: 10.1080/01443615.2022.2033186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Christos Iavazzo
- Gynaecological Oncology Department, Metaxa Cancer Hospital, Piraeus, Greece
| | - Ioannis D Gkegkes
- Athens Colorectal Laboratory, Athens, Greece.,Department of Colorectal Surgery, Royal Devon and Exeter NHS Foundation Trust, 17c James House, Residential Village, EX2 5DS, Bovemoors Lane, Exeter, UK
| | - Nikolaos Vrachnis
- Third Department of Obstetrics and Gynaecology, National and Kapodistrian University of Athens Medical School, Attikon Hospital, Athens, Greece
| |
Collapse
|
5
|
Chan YY, Chu DI, Hirsch J, Kim S, Rosoklija I, Studer A, Brockel MA, Cheng EY, Raval MV, Burjek NE, Rove KO, Yerkes EB. Implementation and sustainability of an enhanced recovery pathway in pediatric bladder reconstruction: Flexibility, commitment, teamwork. J Pediatr Urol 2021; 17:782-789. [PMID: 34521600 PMCID: PMC8678202 DOI: 10.1016/j.jpurol.2021.08.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 08/22/2021] [Accepted: 08/28/2021] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Although enhanced recovery pathways (ERP) provide a safe and effective way to improve the recovery of children undergoing bladder reconstruction, ERPs have not been widely adopted in pediatric urology. We describe a quality improvement initiative and outcomes after implementing a 24-element ERP at a single, freestanding children's hospital. STUDY DESIGN Multiple stakeholder meetings were planned and executed, initially with pediatric practitioners with ERP experience to understand potential implementation barriers then with anesthesiologists, nurses, case managers, and other ancillary staff to draft our institution-specific ERP. A standardized order set was generated to improve ERP adherence. ERP adherence audits and cyclic performance evaluations held every 6-9 months facilitated continuous pathway refinement. Patient outcomes were compared with a pre-ERP historic cohort. RESULTS Time from initial ERP planning to first implementation was 7 months. ERP was implemented in twenty consecutive patients undergoing bladder reconstruction (median age 11.3 years, range 4.1-21.1) who were compared to twenty consecutive pre-ERP patients (median age 11.4 years, range 7.7-25.1). Median post-operative length of stay (LOS) significantly decreased from 9 days (range 2-31) pre-ERP to 4 days (range 3-29) post-ERP (p < 0.05). A median of 16 (range 12-19) of 24 institutional pathway elements were implemented for each patient. Balancing measures showed no significant increases in highest Clavien complication grade, readmission rate, or unplanned return to the operating room within 30 post-operative days. DISCUSSION Implementation of ERP is feasible but requires commitment from multi-disciplinary stakeholders. While we were unable to consistently achieve 80% of the elements, we successfully implemented the pathway and improved our patients' recovery processes (indirectly reflected by a decreased post-operative LOS) with adherence to a median of 67% of elements. Our implementation and effectiveness results are specific to our center and may not be generalizable. However, our experience may offer some insight for others interested in ERP implementation and encourage initiation of their own institutional pathways. CONCLUSION Successful ERP implementation at our hospital for children undergoing bladder reconstruction was facilitated by open communication, early stakeholder involvement, and monitoring ERP adherence. ERP implementation significantly decreased LOS without increasing post-operative complications and readmissions (Summary figure).
Collapse
Affiliation(s)
- Yvonne Y Chan
- Division of Pediatric Urology, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - David I Chu
- Division of Pediatric Urology, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.
| | - Josephine Hirsch
- Division of Pediatric Urology, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Soojin Kim
- Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Ilina Rosoklija
- Division of Pediatric Urology, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Abbey Studer
- Center for Clinical Quality and Safety, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Megan A Brockel
- Department of Anesthesiology, Children's Hospital Colorado, Aurora, CO, USA
| | - Earl Y Cheng
- Division of Pediatric Urology, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Mehul V Raval
- Division of Pediatric Surgery, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Nicholas E Burjek
- Department of Pediatric Anesthesia, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Kyle O Rove
- Department of Pediatric Urology, Children's Hospital Colorado, Aurora, CO, USA
| | - Elizabeth B Yerkes
- Division of Pediatric Urology, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA. https://twitter.com/ebyerkes
| |
Collapse
|
6
|
Patton ME, Leise BS, Baker RE, Andrews FM. The effects of bit chewing on borborygmi, duodenal motility, and gastrointestinal transit time in clinically normal horses. Vet Surg 2021; 51:88-96. [PMID: 34775623 DOI: 10.1111/vsu.13745] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 08/12/2021] [Accepted: 10/21/2021] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To determine the influence of bit chewing on gastrointestinal transit in clinically normal horses. STUDY DESIGN Prospective crossover designed study. ANIMALS Six healthy adult horses. METHODS Horses were assigned randomly to treatment (apple flavored bit) and control (no-bit) groups and studied for 2 × 1-week trial periods with a 2-week washout period between trials. Horses were fasted for 24 h and slowly refed over 3 days. The bit was placed for 20 min every 6 h. Duodenal contractions and borborygmi auscultations were evaluated every 12 h, approximately 5 min following bit placement. Gastrointestinal total transit time (GI TTT) was measured by administering 200 colored beads via stomach tube and then collected in the manure until 50% and 80% were recovered. Measured variables were compared using an ANOVA or Wilcoxon signed-rank test and the P value was noted. RESULTS The GI TTT was shortened in the bit chewing group (median: 106.37 h, range: 70-171 h) compared to the no-bit group (median: 170.1 h, range: 149-186 h) (P = .0156) at 80% bead passage (only 4/6 horses passed 80%). Borborygmi (P = .8193), duodenal contractions (P = .2605), and 50% bead passage (P = .0781) showed no differences. CONCLUSION Bit chewing was safe, inexpensive, and well tolerated. Bit chewing shortened GI TTT and might be an adjunct therapy to augment GI TTT. Further clinical studies are warranted. CLINICAL SIGNIFICANCE Ileus is a common complication following equine abdominal surgery with no current consistently successful treatment. Bit chewing may be a simple and inexpensive way to augment progressive GI motility.
Collapse
Affiliation(s)
- Molly E Patton
- Equine Health Studies Program, Department of Veterinary Clinical Sciences, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Britta S Leise
- Equine Health Studies Program, Department of Veterinary Clinical Sciences, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Rose E Baker
- Equine Health Studies Program, Department of Veterinary Clinical Sciences, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Frank M Andrews
- Equine Health Studies Program, Department of Veterinary Clinical Sciences, Louisiana State University, Baton Rouge, Louisiana, USA
| |
Collapse
|
7
|
Kusika NP, Hutagaol IEB, Yusuf M, Suyanto S, Tilusari SP. The Role of Chewing Gum on Post-operative Bowel Recovery after Gynecological Laparoscopic Surgery: A Short Report and Updated Review. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.7133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Adverse post-operative complication of gynecological laparoscopic surgery, post-operative ileus, could be reduced by mimicking early post-operative oral feeding; however, the role of chewing gum is still lack evidence.
AIM: This study was conducted to assess chewing gum’s role in post-operative bowel recovery after gynecological laparoscopic surgery.
METHODS: This prospective clinical trial recruited 60 participants who had undergone gynecological laparoscopic surgery under general anesthesia. The study was conducted at Arifin Achmad Hospital, Riau Province, Indonesia, from January to April 2021. The patients were equally divided into two groups: Intervention (n = 30) and control (n = 30). They were asked to chew sugar-free gum every 2 h after the surgery (i.e. 5 times within 10 h post-surgery). Time of the first flatus and the first bowel sounds were recorded (i.e. 5 times of assessment within 10 h post-surgery). In addition, a literature review was conducted to add evidence of the role of chewing gum on postoperative bowel recovery after gynecological laparoscopic surgery.
RESULTS: Patients from both groups had a close age range (23–44-year-old versus 21–42-year-old). Our data suggested a significant difference in the time of the first flatus between the treatment and control group (15.95 h vs. 45.05 h), p < 0.001. The length of stay in the hospital among those from the treatment group was also significantly shorter compared to controls (15.50 h vs. 45.50 h), p < 0.001. The literature review of four updated randomized clinical trials suggests chewing gum in the early onset of first flatus and bowel movement.
CONCLUSION: Chewing gum following gynecological laparoscopic surgery could accelerate gastrointestinal recovery.
Collapse
|
8
|
Comparison of treatment to improve gastrointestinal functions after colorectal surgery within enhanced recovery programmes: a systematic review and meta-analysis. Sci Rep 2021; 11:7423. [PMID: 33795783 PMCID: PMC8016851 DOI: 10.1038/s41598-021-86699-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 03/10/2021] [Indexed: 02/01/2023] Open
Abstract
Despite a significant improvement with enhanced recovery programmes (ERP), gastro-intestinal (GI) functions that are impaired after colorectal resection and postoperative ileus (POI) remain a significant issue. In the literature, there is little evidence of the distinction between the treatment assessed within or outside ERP. The purpose was to evaluate the efficiency of treatments to reduce POI and improve GI function recovery within ERP. A search was performed in PubMed and Scopus on 20 September 2019. The studies were included if they compared the effect of the administration of a treatment aiming to treat or prevent POI or improve the early functional outcomes of colorectal surgery within an ERP. The main outcome measures were the occurrence of postoperative ileus, time to first flatus and time to first bowel movement. Treatments that were assessed at least three times were included in a meta-analysis. Among the analysed studies, 28 met the eligibility criteria. Six of them focused on chewing-gum and were only randomized controlled trials (RCT) and 8 of them focused on Alvimopan but none of them were RCT. The other measures were assessed in less than 3 studies over RCTs (n = 11) or retrospective studies (n = 2). In the meta-analysis, chewing gum had no significant effect on the endpoints and Alvimopan allowed a significant reduction of the occurrence of POI. Chewing-gum was not effective on GI function recovery in ERP but Alvimopan and the other measures were not sufficiently studies to draw conclusion. Randomised controlled trials are needed.Systematic review registration number CRD42020167339.
Collapse
|
9
|
Namikawa T, Yamaguchi S, Fujisawa K, Ogawa M, Iwabu J, Munekage M, Uemura S, Maeda H, Kitagawa H, Kobayashi M, Matsuda K, Hanazaki K. Real-time bowel sound analysis using newly developed device in patients undergoing gastric surgery for gastric tumor. JGH OPEN 2021; 5:454-458. [PMID: 33860095 PMCID: PMC8035471 DOI: 10.1002/jgh3.12515] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 01/15/2021] [Accepted: 02/13/2021] [Indexed: 02/05/2023]
Abstract
Background and Aim Objective measurements are not available for determining bowel sounds. The present study sought to evaluate the efficacy of a novel bowel sound monitoring system for perioperative use in patients undergoing gastric surgery. Methods The study enrolled 14 patients who underwent surgery for gastric cancer at Kochi Medical School from 2017 to 2018. Preoperative and postoperative bowel sounds were recorded using a newly developed real‐time analysis system in the operating theater and recovery room. Clinical information and bowel sound count data were obtained to compare preoperative and postoperative measures. Results The median preoperative and postoperative bowel sound counts across all patients were 1.4 and 2.5 counts per minute (cpm), respectively. In patients who underwent laparoscopic gastrectomy, the postoperative bowel sound count was significantly higher than that recorded preoperatively (2.3 vs. 1.6 cpm, P = 0.005). The findings also revealed a significant negative correlation between postoperative bowel sound count and operation time (r = −0.714, P = 0.003). Conclusions The real‐time bowel sound analysis system tested herein presents a promising diagnostic tool to quantitatively evaluate bowel movements associated with surgery. Our results suggested a need for shorter operation times for gastric procedures with respect to peristalsis recovery and supported the use of minimally invasive surgery.
Collapse
Affiliation(s)
| | - Sachi Yamaguchi
- Department of Surgery Kochi Medical School Nankoku Kochi Japan
| | - Kazune Fujisawa
- Department of Surgery Kochi Medical School Nankoku Kochi Japan
| | - Maho Ogawa
- Department of Surgery Kochi Medical School Nankoku Kochi Japan
| | - Jun Iwabu
- Department of Surgery Kochi Medical School Nankoku Kochi Japan
| | - Masaya Munekage
- Department of Surgery Kochi Medical School Nankoku Kochi Japan
| | - Sunao Uemura
- Department of Surgery Kochi Medical School Nankoku Kochi Japan
| | - Hiromichi Maeda
- Department of Surgery Kochi Medical School Nankoku Kochi Japan
| | | | - Michiya Kobayashi
- Department of Human Health and Medical Sciences Kochi Medical School Nankoku Kochi Japan
| | - Kenichi Matsuda
- Department of Emergency and Critical Care Medicine, Faculty of Medicine University of Yamanashi Chuo Yamanashi Japan
| | | |
Collapse
|
10
|
Bisch S, Nelson G, Altman A. Impact of Nutrition on Enhanced Recovery After Surgery (ERAS) in Gynecologic Oncology. Nutrients 2019; 11:nu11051088. [PMID: 31100877 PMCID: PMC6567220 DOI: 10.3390/nu11051088] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Revised: 05/06/2019] [Accepted: 05/11/2019] [Indexed: 12/11/2022] Open
Abstract
Enhanced recovery after surgery (ERAS) pathways aim to improve surgical outcomes by applying evidence-based practices before, during, and after surgery. Patients undergoing surgery for gynecologic malignancies are at high risk of complications due to population, patient, disease, and surgical factors. The nutritional status of the patient provides the foundation for recovery after surgery, and opportunities to optimize outcomes exist from the first patient assessment to the early days after surgery. This review highlights the importance of nutritional assessment and intervention during the pre-operative and post-operative periods in the context of ERAS in gynecologic oncology surgery. The emerging role of immunonutrition, carbohydrate loading, and the importance of individualized care are explored. Evidence from studies in gynecologic oncology is presented, where available, and extrapolated from colorectal and other cancer surgery trials when applicable.
Collapse
Affiliation(s)
- Steven Bisch
- Division of Gynecologic Oncology, Tom Baker Cancer Centre, Calgary, AB T2N4N2, Canada.
| | - Gregg Nelson
- Division of Gynecologic Oncology, Tom Baker Cancer Centre, Calgary, AB T2N4N2, Canada.
| | - Alon Altman
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Manitoba, Winnipeg, MB R3A 1R9, Canada.
| |
Collapse
|
11
|
Wong I, Law S. Early oral intake through meticulous chewing after esophagectomy. J Thorac Dis 2018; 10:S2070-S2073. [PMID: 30023121 DOI: 10.21037/jtd.2018.05.186] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Ian Wong
- Division of Esophageal and Upper Gastrointestinal Surgery, Department of Surgery, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China
| | - Simon Law
- Division of Esophageal and Upper Gastrointestinal Surgery, Department of Surgery, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China
| |
Collapse
|
12
|
Lambrichts DPV, Lange JF. Response to 'Gum chewing aids bowel function return and analgesic requirements after bowel surgery: a randomised controlled trial'. Colorectal Dis 2018; 20:450. [PMID: 29323446 DOI: 10.1111/codi.14012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Accepted: 12/30/2017] [Indexed: 02/08/2023]
Affiliation(s)
- D P V Lambrichts
- Department of Surgery, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - J F Lange
- Department of Surgery, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands.,Department of Surgery, Havenziekenhuis Rotterdam, Rotterdam, The Netherlands.,Department of Surgery, IJsselland Ziekenhuis, Capelle aan den IJssel, The Netherlands
| |
Collapse
|
13
|
Byrne CM, Young CJ, Zahid A. Reply to response to 'Gum chewing aids bowel function return and analgesic requirements after bowel surgery: a randomized controlled trial'. Colorectal Dis 2018; 20:450-451. [PMID: 29406594 DOI: 10.1111/codi.14041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 01/29/2018] [Indexed: 02/08/2023]
Affiliation(s)
- C M Byrne
- Department of Colorectal Surgery, Royal Prince Alfred Hospital, Camperdown, NSW, 2050, Australia
| | - C J Young
- Department of Colorectal Surgery, Royal Prince Alfred Hospital, Camperdown, NSW, 2050, Australia
| | - A Zahid
- Department of Colorectal Surgery, Royal Prince Alfred Hospital, Camperdown, NSW, 2050, Australia
| |
Collapse
|