Daikenchuto for reducing postoperative ileus in patients undergoing elective abdominal surgery

Published on Jun 29, 2016in Cochrane Database of Systematic Reviews9.289
路 DOI :10.1002/14651858.CD012271.PUB2
Nobuaki Hoshino8
Estimated H-index: 8
(Kyoto University),
Toshihiko Takada15
Estimated H-index: 15
(UU: Utrecht University)
+ 3 AuthorsYoshiharu Sakai64
Estimated H-index: 64
(Kyoto University)
Sources
Abstract
BACKGROUND: Postoperative ileus is a major complication for persons undergoing abdominal surgery. Daikenchuto, a Japanese traditional medicine (Kampo), is a drug that may reduce postoperative ileus. OBJECTIVES: To assess the efficacy and safety of Daikenchuto for reducing prolonged postoperative ileus in persons undergoing elective abdominal surgery. SEARCH METHODS: We searched the following databases on 3 July 2017: CENTRAL, MEDLINE, Embase, ICHUSHI, WHO (World Health Organization) International Clinical Trials Registry Platform (ICTRP), EU Crinical Trials registry (EU-CTR), UMIN Clinical Trials Registry (UMIN-CTR), ClinicalTrials.gov, The Japan Society for Oriental Medicine (JSOM), American Society of Clinical Oncology (ASCO), Society of American Gastrointestinal and Endscopic Surgeons (SAGES). We set no limitations on language or date of publication. SELECTION CRITERIA: We included randomised controlled trials (RCTs) comparing Daikenchuto with any control condition in adults, 18 years of age or older, undergoing elective abdominal surgery. DATA COLLECTION AND ANALYSIS: We applied standard methodological procedures expected by Cochrane. Two review authors independently reviewed the articles identified by literature searches, extracted data, and assessed risk of bias of the included studies using the Cochrane software Review Manager 5. MAIN RESULTS: We included seven RCTs with a total of 1202 participants. Overall, we judged the risk of bias as low in four studies and high in three studies. We are uncertain whether Daikenchuto reduced time to first flatus (mean difference (MD) -11.32 hours, 95% confidence interval (CI) -17.45 to -5.19; two RCTs, 83 participants; very low-quality evidence), or time to first bowel movement (MD -9.44 hours, 95% CI -22.22 to 3.35; four RCTs, 500 participants; very low-quality evidence) following surgery. There was little or no difference in time to resumption of regular solid food following surgery (MD 3.64 hours, 95% CI -24.45 to 31.74; two RCTs, 258 participants; low-quality evidence). There were no adverse events in either arm of the five RCTs that reported on drug-related adverse events (risk difference (RD) 0.00, 95% CI -0.02 to 0.02, 568 participants, low-quality evidence). We are uncertain of the effect of Daikenchuto on patient satisfaction (MD 0.09, 95% CI -0.19 to 0.37; one RCT, 81 participants; very low-quality of evidence). There was little or no difference in the incidence of any re-interventions for postoperative ileus before leaving hospital (risk ratio (RR) 0.99, 95% CI 0.06 to 15.62; one RCT, 207 participants; moderate-quality evidence), or length of hospital stay (MD -0.49 days, 95% CI -1.21 to 0.22; three RCTs, 292 participants; low-quality evidence). AUTHORS' CONCLUSIONS: Evidence from current literature was unclear whether Daikenchuto reduced postoperative ileus in patients undergoing elective abdominal surgery, due to the small number of participants in the meta-analyses. Very low-quality evidence means we are uncertain whether Daikenchuto improved postoperative flatus or bowel movement. Further well-designed and adequately powered studies are needed to assess the efficacy of Daikenchuto.
馃摉 Papers frequently viewed together
References42
Newest
#1Ken-ichi Okada (Wakayama Medical University)H-Index: 20
#2Manabu Kawai (Wakayama Medical University)H-Index: 36
Last. Hiroki Yamaue (Wakayama Medical University)H-Index: 69
view all 20 authors...
Background We assessed the efficacy of TJ-100 taken perioperatively to recovery among patients with periampullary tumor or tumor of the head of the pancreas who underwent pancreaticoduodenectomy (PD). Patients and methods In this multicenter, randomized, double-blinded, placebo-controlled, phase II trial (JAPAN-PD Study), patients were assigned randomly in a 1:1 ratio to receive TJ-100 or placebo. The coprimary endpoints were (1) incidence of postoperative paralytic ileus lasting >72聽hours after...
Source
#1Hidetoshi Katsuno (Fujita Health University)H-Index: 12
#2Koutarou Maeda (Fujita Health University)H-Index: 20
Last. Masaki Kitajima (International University of Health and Welfare)H-Index: 21
view all 12 authors...
Background This exploratory trial was conducted to investigate whether daikenchuto accelerates the recovery of gastrointestinal function in patients undergoing open surgery for sigmoid or rectosigmoid cancer.
Source
#1Anne P. Ehlers (UW: University of Washington)H-Index: 8
#2Vlad V. Simianu (UW: University of Washington)H-Index: 12
Last. Farhood Farjah (UW: University of Washington)H-Index: 21
view all 11 authors...
Background Randomized trials have found that alvimopan hastens return of bowel function and reduces length of stay (LOS) by 1 day among patients undergoing colorectal surgery. However, its effectiveness in routine clinical practice and its impact on hospital costs remain uncertain. Study Design We performed a retrospective cohort study of patients undergoing elective colorectal surgery in Washington state (2009 to 2013) using data from a clinical registry (Surgical Care and聽Outcomes Assessment P...
Source
#6Michio Yamamoto (Kyoto University)H-Index: 14
Introduction This multicentre randomised controlled clinical trial will aim to determine the ability of an extract (TJ-100) of Daikenchuto (traditional Japanese herbal medicine; Kampo) to prevent bowel dysfunction in at least 110 patients after liver transplantation (LT). Methods and analysis The following co-primary end points will be evaluated on postoperative day 7: total oral and enteral caloric intake, abdominal distension and abdominal pain. The secondary end points will comprise sequentia...
Source
#1Toru Kono (University of Tokushima)H-Index: 1
#2Mitsuo Shimada (University of Tokushima)H-Index: 91
Last. Yasuhito UezonoH-Index: 26
view all 9 authors...
Herbal medicines have been used in Japan for more than 1500 years and traditional Japanese medicines (Kampo medicines) are now fully integrated into the modern healthcare system. In total, 148 Kampo formulae are officially approved as prescription drugs and covered by the national health insurance system in Japan. However, despite their long track record of clinical use, the multi-targeted, multi-component properties of Kampo medicines, which are fundamentally different from Western medicines, h...
Source
#1Kozo Yoshikawa (University of Tokushima)H-Index: 19
#2Mitsuo Shimada (University of Tokushima)H-Index: 91
Last. Masaki Kitajima (International University of Health and Welfare)H-Index: 21
view all 18 authors...
Background Daikenchuto (DKT) has widely been used to improve abdominal symptoms by being expected to accelerate bowel motility. The purpose of this study is to examine the efficacy and safety of DKT for prevention of ileus and associated gastrointestinal symptoms after total gastrectomy. Study Design Two hundred and forty-five gastric cancer patients who underwent total gastrectomy were enrolled. Patients received either DKT (15.0 g/d) or matching placebo from postoperative days 1 to 12. Primary...
Source
#1Hidetoshi Katsuno (Fujita Health University)H-Index: 12
#2Koutarou Maeda (Fujita Health University)H-Index: 20
Last. Masahiko Watanabe (Kitasato University)H-Index: 53
view all 12 authors...
Objective This exploratory trial was performed to determine whether Daikenchuto accelerates recovery of gastrointestinal function in patients undergoing open colectomy for colon cancer.
Source
#1Gakuji OsawaH-Index: 5
#2Kazuhiko YoshimatsuH-Index: 15
Last. Kenji OgawaH-Index: 24
view all 7 authors...
Abstract We analyzed the effects of the Kampo medicine "Dai-kenchu-to" (DKT) on clinical aspects in colorectal surgery. Total 122 patients who underwent colorectal cancer surgery were divided into a DKT group (n = 53) and a non-DKT group (n = 69). The differences of postoperative course and anti-inflammatory responses between those two groups were analyzed. The 53 out of 59 patients could completely take DKT. In the postoperative course, significant difference was observed in the first flatus da...
#1Vaneesha Short (UoB: University of Bristol)H-Index: 2
#2Georgia Herbert (UoB: University of Bristol)H-Index: 9
Last. Stephen Lewis (Derriford Hospital)H-Index: 21
view all 9 authors...
Background Ileus commonly occurs after abdominal surgery, and is associated with complications and increased length of hospital stay (LOHS). Onset of ileus is considered to be multifactorial, and a variety of preventative methods have been investigated. Chewing gum (CG) is hypothesised to reduce postoperative ileus by stimulating early recovery of gastrointestinal (GI) function, through cephalo-vagal stimulation. There is no comprehensive review of this intervention in abdominal surgery. Objecti...
Source
#1Mitsuo Shimada (University of Tokushima)H-Index: 91
#2Yuji Morine (University of Tokushima)H-Index: 29
Last. Masaki Kitajima (International University of Health and Welfare)H-Index: 21
view all 14 authors...
Background This multi-center, phase III trial assesses the efficacy of daikenchuto (TU-100) on gastrointestinal disorders after hepatic resection (UMIN Registration No. 000003103).
Source
Cited By4
Newest
#1M. Usman Ahmad (University of Colorado Denver)H-Index: 3
#2Keyan D. Riley (University of Colorado Hospital)H-Index: 1
Last. Thomas Ridder (Boston Children's Hospital)H-Index: 6
view all 3 authors...
Background Acute colonic pseudo-obstruction (ACPO) or Ogilvie syndrome occurs in 0.22%鈥7% of patients undergoing surgery, with a mortality of up to 46%. ACPO increased median hospital days versus control in spinal surgery (14 vs. 6 days; P Case Description The patient was a 31-year-old woman with untreated advanced scoliosis with no history of neurologic issues. T2-L3 spinal instrumentation and fusion was completed. Plain abdominal radiography showed dilated cecum 11 cm and the department of gen...
Source
#1Toru Aoyama (YCU: Yokohama City University)H-Index: 26
#2Hiroshi Tamagawa (YCU: Yokohama City University)H-Index: 11
Kampo medicine or Japanese/Chinese traditional herbal medicine has long been used for the treatment of various diseases, mainly in Asian countries. In recent years, Asian investigators have attempted to clarify the mechanism and clinical efficacy of Kampo medicine. This review summarizes the background, current status, and future perspectives of Kampo medicine in the multimodal treatment of gastrointestinal cancer. Regarding the clinical effect of Kampo medicine on postoperative dysfunction afte...
Source
#1Fumie Oyama (Hirosaki University)H-Index: 1
#2Masayuki Futagami (Hirosaki University)H-Index: 15
Last. Yoshihito Yokoyama (Hirosaki University)H-Index: 30
view all 10 authors...
BACKGROUND: Postoperative ileus is a major complication of abdominal surgical procedures. The purpose of this study was to investigate preventive effect of daikenchuto (DKT) on onset of ileus in patients who received gynecological surgery for malignant tumors. METHODS: A total of 904 patients who received gynecological surgery for malignant tumors by opening retroperitoneum along with retroperitoneal lymph node dissection during a period between 2004 and 2018 were included in this retrospective ...
Source
This website uses cookies.
We use cookies to improve your online experience. By continuing to use our website we assume you agree to the placement of these cookies.
To learn more, you can find in our Privacy Policy.