Lambrichts DPV, et al. – For the first time, this multicenter, double–blind, randomised, controlled pilot study aimed to evaluate efficacy and safety of nicotine gum for the prevention of postoperative ileus (POI) after colorectal surgery. In improving gastrointestinal recovery and prevention of prolonged POI (PPOI) after colorectal surgery, the clinicians proved nicotine gum to be safe but ineffective. Other dosages and administration routes of nicotine needed to be examined in future research.

• The clinicians enrolled patients underwent elective oncological colorectal surgery in this double-blind, parallel-group, controlled trial.
• Patients were randomly assigned to a treatment protocol with normal or nicotine gum (2 mg).
• They collected patient reported outcomes (PROMS), clinical characteristics and blood samples.
• They defined primary endpoint as time to first passage of faeces and toleration of solid food for at least 24 h.

• The clinicians enrolled 40 patients (20 vs. 20).
• 6 patients developed PPOI in both groups.
• Between normal and nicotine gum, time to primary endpoint (4.50 [3.00–7.25] vs. 3.50 days [3.00–4.25], p = 0.398) and length of stay (5.50 [4.00–8.50] vs. 4.50 days [4.00–6.00], p = 0.738) did not differ significantly.
• They found no differences in PROMS, inflammatory parameters and postoperative complications.