Kono, Toru Sapporo Higashi Tokushukai Hospital
Katsuno, Hidetoshi Fujita Health University
Maeda, Koutarou Fujita Health University
Koeda, Keisuke Iwate Medical University
Morita, Satoshi Kyoto University
渡邊, 正彦 Kitasato University
Kusano, Mitsuo Ohta General Hospital Foundation Ohta Atami Hospital
Sakamoto, Junichi Tokai Central Hospital
Saji, Shigetoyo Japanese Foundation for Multidisciplinary Treatment of Cancer
Sokuoka, Hiroki Japanese Foundation for Multidisciplinary Treatment of Cancer
Sato, Yasuto Tokyo Women’s Medical University
Maehara, Yoshihiko Japanese Foundation for Multidisciplinary Treatment of Cancer
Kanematsu, Takashi Nagasaki City Hospital Organization
Kitajima, Masaki International University of Health and Welfare
Body mass index
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).
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.
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.
The subgroup analysis showed that DKT significantly accelerated the recovery from prolonged POI following OAS.
Japan Surgical Society|Springer Nature
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