• Madhuri Pattamatta, SmeetsBoudewijn J JBJJb Department of Surgery , Catharina Hospital Eindhoven , Eindhoven , The Netherlands.c GROW School of oncology and developmental biology , Maastricht University , Maastricht , The Netherlands., EversSilvia M A ASMAAhttp://orcid.org/0000-0003-1026-570Xa Department of Health Services Research, CAPHRI School for Public Health and Primary Care , Maastricht University , Maastricht , The Netherlands.d Trimbos Institute of Mental Health and Addiction ,, RuttenHarm J THJThttp://orcid.org/0000-0003-2532-950Xb Department of Surgery , Catharina Hospital Eindhoven , Eindhoven , The Netherlands.c GROW School of oncology and developmental biology , Maastricht University , Maastricht , The Netherlands., LuyerMisha D PMDPhttp://orcid.org/0000-0002-9483-1520b Department of Surgery , Catharina Hospital Eindhoven , Eindhoven , The Netherlands., and Mickael Hiligsmann.
• a Department of Health Services Research, CAPHRI School for Public Health and Primary Care , Maastricht University , Maastricht , The Netherlands.
• Acta Chir Belg. 2018 Oct 1; 118 (5): 299-306.

BackgroundPostoperative ileus (POI) and anastomotic leakage (AL) following colorectal surgery severely increase healthcare costs and decrease quality of life. This study evaluates the effects of reducing POI and AL via perioperative gum chewing compared to placebo (control) on in-hospital costs, health-related quality of life (HRQoL), and assesses cost-effectiveness.MethodsIn patients undergoing elective, open colorectal surgery, changes in HRQoL were assessed using EORTC-QLQ-C30 questionnaires and costs were estimated from a hospital perspective. Incremental cost-effectiveness ratios were estimated.ResultsIn 112 patients, mean costs for ward stay were significantly lower in the gum chewing group when compared to control (€3522 (95% CI €3034-€4010) versus €4893 (95% CI €3843-€5942), respectively, p = .020). No differences were observed in mean overall in-hospital costs, or in mean change in any of the HRQoL scores or utilities. Gum chewing was dominant (less costly and more effective) compared to the control in more than 50% of the simulations for both POI and AL.ConclusionReducing POI and AL via gum chewing reduced costs for ward stay, but did not affect overall in-hospital costs, HRQoL, or mapped utilities. More studies with adequate sample sizes using validated questionnaires at standardized time points are needed.

42 keywords...

hide…