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Trial registered on ANZCTR
Registration number
ACTRN12607000538448
Ethics application status
Approved
Date submitted
16/10/2007
Date registered
22/10/2007
Date last updated
3/10/2014
Type of registration
Prospectively registered
Titles & IDs
Public title
Effect of Gum-chewing on Postoperative Recovery of Gut Functions: A Randomised Controlled Clinical Trial
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Scientific title
In adults following surgery involving gastric or bowel resection, with or without primary anastomosis, does the addition of regular gum-chewing in the immediate postoperative period compared to standard postoperative care alone reduce recovery time and length of hospital stay?
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Secondary ID [1]
285435
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Nil known
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Postoperative ileus
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Condition category
Condition code
Surgery
2566
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0
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Other surgery
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Commercially available sugar-free chewing gum in peppermint flavour. One piece is administered four times a day and the participants in the treatment arm are asked to chew the gum for 15minutes each time. Treatment is commenced as soon as practicable following the surgery (usually on admission to ward) and continue until post-operative day 14 or discharge, whichever occurs earlier.
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Intervention code [1]
2195
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Treatment: Other
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Comparator / control treatment
standard postoperative care which includes being kept nil by mouth on the day of the operation and high protein-high energy fluids are commenced on postoperative day 1. High-protein-high-energy fluid is continued until post-operative day 2 and if tolerated, solids are commenced on day 3. Postoperative analgesia are determined by patient needs and may include parenteral or enteral narcotics if required.
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Control group
Active
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Outcomes
Primary outcome [1]
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Time to first bowel motion
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Assessment method [1]
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Timepoint [1]
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daily until the first bowel motion or 14 days have elapsed, whichever occurs first.
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Primary outcome [2]
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time to tolerance of normal diet
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Assessment method [2]
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Timepoint [2]
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from post-operative day 3 until discharge or 14 days have elapsed, whichever occurs first.
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Primary outcome [3]
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Length of stay
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Assessment method [3]
3472
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Timepoint [3]
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at discharge
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Secondary outcome [1]
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Pain score on a visual analogue scale
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Assessment method [1]
5790
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Timepoint [1]
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daily until 14 days have elapsed or dishcarge from hospital, whichever occurs first
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Secondary outcome [2]
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Incidence of symptoms of ileus including nausea, vomiting and bloating
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Assessment method [2]
5791
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Timepoint [2]
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daily until 14 days have elapsed or dishcarge from hospital, whichever occurs first
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Secondary outcome [3]
5792
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Incidence of postoperative complications including prolonged ileus requiring nasogastric tube insertion, wound dehiscence, readmission to intensive care unit, unplanned readmission within 30 days
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Assessment method [3]
5792
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Timepoint [3]
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during trial and at 30 days post-discharge
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Eligibility
Key inclusion criteria
Elective surgery involving any form of gastric or bowel resection with or without primary anastomosis.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Patients with known risk of aspiration eg. cognitively or intellectually impaired, previous stroke with residual neurological deficiency involving the facial-oro-pharyngeal muscles. Patients who require prolonged intubation/sedation immediately post-op.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Potentially suitable patients are identified from the hospital's elective operation list 3-4 days prior to the planned operation. Patients are invited to participate in the study on the day of their operation at the time of admission. Medical records review and physical examination of the patients are performed to ensure patient meet the eligibility criteria and none of the exclusion criteria. Patient information is given and informed consent is obtained. Once the patient has consented, the trial secretary is contacted to obtain the randomisation sequence and the patient is allocated into the arms of the study accordingly. The randomisation sequence is stored in the locked office of one of the main investigators who is not involved in the process of subject recruitment.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Study subjects are stratified into 3 groups of equal sizes and a computer generated sequence of random numbers are produced. The overall balance between treatment and control within each stratum is checked for approximately even distribution.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 2
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
3/09/2007
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Actual
1/06/2008
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Date of last participant enrolment
Anticipated
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Actual
31/03/2011
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
240
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Recruitment postcode(s) [1]
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2305
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Funding & Sponsors
Funding source category [1]
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Self funded/Unfunded
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Name [1]
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Dr Stephen Smith
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Address [1]
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Lookout Road, New Lambton Heights, 2305, NSW
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Country [1]
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Australia
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Primary sponsor type
Hospital
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Name
Division of Surgery, John Hunter Hospital
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Address
Lookout Road, New Lambton Heights, 2305, NSW
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Country
Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Hunter New England Human Research Ethics Committee
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Ethics committee address [1]
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Hunter New England Research Ethics Unit, Locked Bag 1, New Lambton, NSW 2305
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
4631
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Approval date [1]
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02/07/2007
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Ethics approval number [1]
4631
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07/06/20/5.01
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Summary
Brief summary
Postoperative impairment of gut function following gastrointestinal surgery is a major cause of delay in resumption of normal oral intake and discharge from hospital. Gum-chewing as a form of sham-feeding (the act of chewing without swallowing) is thought to have a stimulatory effect on the normal reflexes associated with bowel movement. The purpose of this study is to examine whether this simple and cost-efficient treatment helps to improve recovery time following surgery to the gastrointestinal tract.
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Trial website
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Trial related presentations / publications
Ann Surg. 2013 Jun;257(6):1016-24. doi: 10.1097/SLA.0b013e318286504a. Sham feeding with chewing gum after elective colorectal resectional surgery: a randomized clinical trial. Lim P, Morris OJ, Nolan G, Moore S, Draganic B, Smith SR.
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Public notes
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Contacts
Principal investigator
Name
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Dr Stephen Smith
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Address
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Division of Surgery, John Hunter Hospital Lookout Road, New Lambton Heights, NSW, 2305
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Country
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Australia
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Phone
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+61 2 49563243
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Stephen Smith
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Address
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Division of Surgery, John Hunter Hospital
Lookout Road, New Lambton Heights, NSW, 2305
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Country
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Australia
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Phone
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+61 2 49563243
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Fax
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+61 2 49563246
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Email
11277
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[email protected]
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Contact person for scientific queries
Name
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Stephen Smith
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Address
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Division of Surgery, John Hunter Hospital
Lookout Road, New Labmton Heights, NSW, 2305
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Country
2205
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Australia
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Phone
2205
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+61 2 49563243
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Fax
2205
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+61 2 49563246
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Email
2205
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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