Daikenchuto for reducing postoperative ileus in patients undergoing elective abdominal surgery

Area of Science:

• Gastroenterology
• Pharmacology
• Traditional Japanese Medicine

Background:

• Postoperative ileus is a significant complication following abdominal surgery.
• Daikenchuto, a traditional Japanese Kampo medicine, is being investigated for its potential to mitigate postoperative ileus.

Purpose of the Study:

• To evaluate the efficacy and safety of Daikenchuto in reducing prolonged postoperative ileus.
• To assess the impact of Daikenchuto on recovery metrics after elective abdominal surgery.

Main Methods:

• A systematic review and meta-analysis of randomized controlled trials (RCTs) were conducted.
• Searched multiple databases (CENTRAL, MEDLINE, Embase, etc.) with no date or language restrictions.
• Included seven RCTs involving 1202 adult participants undergoing elective abdominal surgery.

Main Results:

• Evidence regarding Daikenchuto's effect on time to first flatus and bowel movement was of very low quality and uncertain.
• No significant difference was observed in the resumption of solid food intake or length of hospital stay.
• No adverse events were reported in five RCTs, with low-quality evidence suggesting no difference in re-interventions.

Conclusions:

• Current evidence is insufficient to confirm Daikenchuto's effectiveness in reducing postoperative ileus due to small meta-analysis sample sizes.
• Very low-quality evidence leads to uncertainty about Daikenchuto's benefits on postoperative flatus and bowel movements.
• Further well-designed, adequately powered studies are required to definitively assess the efficacy of Daikenchuto.