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Daikenchuto accelerates the recovery from prolonged postoperative ileus after open abdominal surgery: a subgroup analysis of three randomized controlled trials.

Abstract：

PURPOSE:Prolonged postoperative ileus (POI) is a common complication after open abdominal surgery (OAS). Daikenchuto (DKT), a traditional Japanese medicine that peripherally stimulates the neurogenic pathway, is used to treat prolonged POI in Japan. To analyze whether DKT accelerates the recovery from prolonged POI after OAS, we conducted a secondary analysis of three multicenter randomized controlled trials (RCTs). METHODS:A secondary analysis of the three RCTs supported by the Japanese Foundation for Multidisciplinary Treatment of Cancer (project numbers 39-0902, 40-1001, 42-1002) assessing the effect of DKT on prolonged POI in patients who had undergone OAS for colon, liver, or gastric cancer was performed. The subgroup included 410 patients with no bowel movement (BM) before the first diet, a DKT group (n = 214), and a placebo group (n = 196). Patients received either 5 g DKT or a placebo orally, three times a day. The primary endpoint was defined as the time from the end of surgery to the first bowel movement (FBM). A sensitivity analysis was also performed on the age, body mass index and dosage as subgroup analyses. RESULTS:The primary endpoint was significantly accelerated in the DKT group compared with the placebo group (p = 0.004; hazard ratio 1.337). The median time to the FBM was 113.8 h in the placebo group and 99.1 h in the DKT treatment group. CONCLUSIONS:The subgroup analysis showed that DKT significantly accelerated the recovery from prolonged POI following OAS. TRIAL REGISTRATION NUMBER:UMIN000026292.

journal_name

Surg Today

journal_title

Surgery today

authors

Kono T,Shimada M,Nishi M,Morine Y,Yoshikawa K,Katsuno H,Maeda K,Koeda K,Morita S,Watanabe M,Kusano M,Sakamoto J,Saji S,Sokuoka H,Sato Y,Maehara Y,Kanematsu T,Kitajima M

doi

10.1007/s00595-019-01787-9

subject

Has Abstract

pub_date

2019-08-01 00:00:00

pages

704-711

issue

8

eissn

0941-1291

issn

1436-2813

pii

10.1007/s00595-019-01787-9

journal_volume

49

pub_type

杂志文章

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