Scholarlink

Backgrounds <p>Postoperative intestinal dysfunction is a major complication following abdominal surgery. Daikenchuto (DKT), Japanese herbal (Kampo) medicine, has been investigated the efficacy for postoperative intestinal dysfunction. However, the studies have conveyed inconclusive results and previous meta-analysis included not only true randomized controlled trials (RCTs), but low-quality RCTs.</p> Methods <p>A comprehensive electronic literature search was conducted through April 2025 to identify true RCTs comparing patients between with or without perioperative DKT administration in gastroenterological cancer surgery. The primary outcome was the time to first postoperative flatus. A meta-analysis was performed using random-effects models to calculate mean difference (MD) with 95% confidence intervals (CIs).</p> Results <p>Eleven true RCTs involving 1413 patients (with DKT group, <i>n</i> = 716; Without DKT group, <i>n</i> = 697) were included. The meta-analysis demonstrated a significant improvement of the time to first postoperative flatus in the With DKT group than in the Without DKT group, with an MD of −&#xa0;0.19 (95% CI −&#xa0;0.34 to −&#xa0;0.04, <i>P</i> = 0.01), and no significant between-study heterogeneity was observed (<i>χ</i><sup>2</sup> = 8.12, <i>I</i><sup>2</sup> = 26%, <i>P</i> = 0.23). Subgroup analysis demonstrated a significantly shorter time to first postoperative flatus in categories of surgery other than colorectal, studies of double-blinded, multi-institutional, 100 or more patients included.</p> Conclusions <p>This meta-analysis suggests that DKT can improve postoperative intestinal dysfunction (<i>i.e.</i>, first postoperative flatus) after gastroenterological cancer surgery, but the efficacy was modest. Thus, the efficacy of DKT on improving postoperative intestinal dysfunction warrants further investigation in more high quality RCTs.</p> Registry and registration number <p>This systematic review and meta-analysis was registered with UMIN-CTR (ID: UMIN000066046) (<a href="https://www.umin.ac.jp/ctr/index-j.htm">https://www.umin.ac.jp/ctr/index-j.htm</a>).</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Is daikenchuto effective for postoperative intestinal dysfunction after gastroenterological cancer surgery? An updated meta-analysis of randomized controlled trials

  • 期刊论文

  • 发表日期：

    2025年8月17日

查看全文
  • Hideki Kogo,
  • Akihisa Matsuda,
  • Yasuyuki Negishi,
  • Rimpei Morita,
  • Hiroshi Yoshida

摘要

Backgrounds

Postoperative intestinal dysfunction is a major complication following abdominal surgery. Daikenchuto (DKT), Japanese herbal (Kampo) medicine, has been investigated the efficacy for postoperative intestinal dysfunction. However, the studies have conveyed inconclusive results and previous meta-analysis included not only true randomized controlled trials (RCTs), but low-quality RCTs.

Methods

A comprehensive electronic literature search was conducted through April 2025 to identify true RCTs comparing patients between with or without perioperative DKT administration in gastroenterological cancer surgery. The primary outcome was the time to first postoperative flatus. A meta-analysis was performed using random-effects models to calculate mean difference (MD) with 95% confidence intervals (CIs).

Results

Eleven true RCTs involving 1413 patients (with DKT group, n = 716; Without DKT group, n = 697) were included. The meta-analysis demonstrated a significant improvement of the time to first postoperative flatus in the With DKT group than in the Without DKT group, with an MD of − 0.19 (95% CI − 0.34 to − 0.04, P = 0.01), and no significant between-study heterogeneity was observed (χ2 = 8.12, I2 = 26%, P = 0.23). Subgroup analysis demonstrated a significantly shorter time to first postoperative flatus in categories of surgery other than colorectal, studies of double-blinded, multi-institutional, 100 or more patients included.

Conclusions

This meta-analysis suggests that DKT can improve postoperative intestinal dysfunction (i.e., first postoperative flatus) after gastroenterological cancer surgery, but the efficacy was modest. Thus, the efficacy of DKT on improving postoperative intestinal dysfunction warrants further investigation in more high quality RCTs.

Registry and registration number

This systematic review and meta-analysis was registered with UMIN-CTR (ID: UMIN000066046) (https://www.umin.ac.jp/ctr/index-j.htm).