Nicotine Gum Recovery After Colorectal Surgery

• Hospital stay [ Time Frame: 30 days ] [ Designated as safety issue: No ]
  Length of postoperative hospital stay
• Post-operative vomiting [ Time Frame: 30 days ] [ Designated as safety issue: No ]
  Episodes of vomiting
• Use of NG Tubes [ Time Frame: 30 days ] [ Designated as safety issue: No ]
  Nasogastric tube (re)insertions

The purpose of this study is to evaluate whether the use of nicotine gum in the postoperative period influences surgical outcome in patients undergoing colorectal surgery.

The main hypothesis of this study is that use of nicotine gum after colorectal surgery will accelerate recovery of bowel function. Eligible patients include all patients undergoing segmental small bowel or large bowel resection with a planned primary anastomosis, planned removal of the nasogastric tube at the end of the surgery, and administration of clear liquids on post-operative day one. Patients who have an ileostomy or colostomy created will be excluded. Patients enrolled in the study will be randomized to one of three groups: nicotine gum, regular gum, or no gum. Patients randomized to nicotine gum or regular gum will chew the gum three times a day for 1 week. The main outcome measure is time to first bowel movement or flatus.

• Drug: Nicotine gum
  Patients will chew nicotine gum 3 times a day until discharge or 7 days, whichever comes first
  Other Name: Nicorrete gum
• Other: Regular chewing gum
  Patients will chew regular sugar-free gum 3 times a day until discharge or 7 days, whichever comes first
  Other Name: Sugarlees chewing gum

• Active Comparator: Nicotine gum
  100 subjects who will actually get the intervention medication
  Intervention: Drug: Nicotine gum
• Sham Comparator: regular chewing gum
  100 subjects who will be part of a control group
  Intervention: Other: Regular chewing gum
• No Intervention: No gum
  100 subjects who will not get neither the intervention nor the placebo gum.

Inclusion Criteria:

• Able to freely give written informed consent to participate in the study and have signed the Informed Consent Form;
• Due to undergo small and/or large partial bowel resection via laparotomy or laparoscopy;

Exclusion Criteria:

• Prior intestinal surgery
• Mentally incompetent or unable or unwilling to provide informed consent or comply with study procedures
• American Society of Anesthesiologists (ASA) Class IV or V;
• History of abdominal carcinomatosis;
• History of radiation enteritis;
• Children < 18 or adults > 85 years of age
• Pregnant women
• Current cigarette, cigar smokers and chewers of tobacco. ex smokers who quit less than 3 months ago.
• Patients requiring postoperative ventilation, pressor requirement or ICU stay
• Patients with prior cardiovascular disorders