Effects of Daikenchuto on postoperative gastrointestinal motility in colorectal carcinoma patients with abdominal pain a
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ORIGINAL ARTICLE
Effects of Daikenchuto on postoperative gastrointestinal motility in colorectal carcinoma patients with abdominal pain and distension: a prospective, randomized trial Masaki Wakasugi1 · Yozo Suzuki1 · Mitsuyoshi Tei1 · Shigeyuki Ueshima1 · Hiroki Akamatsu1 · Toshirou Nishida1 Received: 15 April 2020 / Accepted: 17 May 2020 © Springer Nature Singapore Pte Ltd. 2020
Abstract Purpose To investigate the efficacy and safety of Daikenchuto (DKT) for colorectal cancer patients undergoing surgery with the potential risk of postoperative ileus (POI). Methods Colorectal cancer patients with abdominal pain and distention, scheduled for surgery, were randomly assigned to a DKT group or a control group. Patients assigned to the DKT group were given 15 g of DKT per day during the perioperative period. We then compared the perioperative gastrointestinal symptoms between the two groups. Results The aim for a sample size of 30 patients per group was not reached in time, so we conducted an analysis on 16 patients in each group. The visual Analogue Scale scores for abdominal pain and distention were similar in the two groups. The number of bowel movements per day on postoperative days (PODs) 1, 2, and 6 were significantly lower in the DKT group. The incidence of a sensation of incomplete bowel evacuation on PODs 3 and 28 was also significantly lower in the DKT group. There were no adverse events thought to be related to DKT. Conclusions DKT could potentially inhibit diarrhea and reduce the number of bowel movements per day and the sensation of incomplete bowel evacuation after colorectal surgery. Thus, the perioperative use of DKT may be safe for colorectal cancer patients with abdominal pain and distention, who undergo surgery. Keywords Daikenchuto · Colorectal surgery · Postoperative ileus
Introduction The concept of enhanced recovery after surgery (ERAS) has been developed to improve the postoperative course of patients after abdominal surgery [1]. ERAS includes 17 different items, ranging from preoperative counselling and feeding, perioperative measures to postoperative mobilization, and early feeding. Most of the items are chosen on the basis of high-grade evidence of clinical effectiveness [2]. While drug therapy, including prokinetics, may improve intestinal motility and consequently, the postoperative Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00595-020-02052-0) contains supplementary material, which is available to authorized users. * Masaki Wakasugi [email protected] 1
Department of Surgery, Osaka Police Hospital, 10‑31 Kitayama‑cho, Tennouji‑ku, Osaka 543‑0035, Japan
outcomes of patients undergoing colorectal surgery, there are no specific medicines in the ERAS program. Postoperative ileus (POI) is an abnormal pattern of gastrointestinal motility, characterized by nausea, vomiting, abdominal pain/distention, and/or delayed passage of flatus or stool, which can occur after surgery [3]. Patients with POI usually recover within 72 h
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