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Ann Surg Treat Res. 2018 Jul;95(1):7-15. English. Meta-Analysis. https://doi.org/10.4174/astr.2018.95.1.7
Zhang L , Cheng Y , Li H , Zhou Y , Sun B , Xu L .
Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation and Department of Biliary-Pancreatic Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China. leiboxumd@163.com
Department of Hepatic Surgery, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Department of Orthopaedics, The Fifth Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
Laboratory Animal Center, Sun Yat-sen University, Guangzhou, China.
International Pacific Research Center, University of Hawaii at Manoa, Honolulu, HI, USA.
Abstract

Purpose

Intestinal dysfunction is one of the most common complications in patients after abdominal surgery. Daikenchuto (DKT), a traditional herbal medicine, is recently employed to improve postoperative intestinal dysfunction. The aim of this meta-analysis was to assess the efficacy of DKT in improving intestinal dysfunction after abdominal surgery.

Methods

PubMed, Embase, and the Cochrane library were systematically searched to identify randomized controlled trails (RCTs) in adult patients undergoing abdominal surgery, who were randomly distributed to administrate DKT and placebo. The primary outcomes included the time to first postoperative flatus or bowel movement. We used random-effects models to calculate summary mean differences (MDs) with 95% confidence intervals (CIs).

Results

Nine RCTs totaling 1,212 patients (618 in DKT, 594 in control group) were included in our study. Compared with control group, DKT can effectively improve postoperative intestinal dysfunction by shortening the time to first postoperative flatus (MD, −0.41; 95% confidence interval [CI], −0.66 to −0.16; P = 0.001) with significant heterogeneity (I² = 71%, P = 0.004), and bowel movement (MD, −0.65; 95% CI, −0.97 to −0.32; P < 0.001) without significant heterogeneity (I² = 40%, P = 0.14). Sensitivity analyses by indication of surgery and type of surgery yielded similar results.

Conclusion

These data provide limited evidence that DKT shows efficacy on improving intestinal dysfunction after abdominal surgery. However, the results should be interpreted cautiously, due to the heterogeneity of the studies included. Thus, the efficacy of DKT on improving postoperative intestinal dysfunction warrants further investigation.

Copyright © 2019. Korean Association of Medical Journal Editors.