Dai-kenchu-to, a Chinese herbal medicine, improves stasis of patients with total gastrectomy and jejunal pouch interposition

Endo, Shunji; Nishida, Toshirou; Nishikawa, Kazuhiro; Nakajima, Kiyokazu; Hasegawa, Junichi; Kitagawa, Toru; Ito, Toshinori; Matsuda, Hikaru

doi:10.1016/j.amjsurg.2006.01.022

Cited by 75 publications

(61 citation statements)

References 16 publications

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“…Dai-kenchu-to (DKT) is reported to be effective in treating uncomplicated postoperative intestinal obstruction (Ito et al, 2002;Ohya et al, 2003;Endo et al, 2006). It has been considered that DKT improves postoperative ileus by exerting gastroprokinetics effects on gastrointestinal tract.…”

Section: Discussionmentioning

confidence: 99%

“…DKT is used conventionally for abdominal distention in Japan. It has been shown recently that DKT is useful for treatment of postoperative ileus, postoperative intestinal paralysis, irritable bowel syndrome and pediatric constipation (Ito et al, 2002;Ohya et al, 2003;Endo et al, 2006). DKT seems to improve postoperative quality of life (QOL) of patients after surgery for gastrointestinal disorders, since it makes possible for patients to shorten their duration of hospitalization (Endo et al, 2006).…”

Section: Introductionmentioning

confidence: 99%

“…It has been shown recently that DKT is useful for treatment of postoperative ileus, postoperative intestinal paralysis, irritable bowel syndrome and pediatric constipation (Ito et al, 2002;Ohya et al, 2003;Endo et al, 2006). DKT seems to improve postoperative quality of life (QOL) of patients after surgery for gastrointestinal disorders, since it makes possible for patients to shorten their duration of hospitalization (Endo et al, 2006). DKT ameliorates gastrointestinal dysfunction through various effects, such as contraction and relaxation of smooth muscles (Furukawa et al, 1995;Kurosawa et al, 1998;Hayakawa et al, 1999b;Satoh K et al, 2001aSatoh K et al, , 2001bTulimat et al, 2001), increase of blood flow in mesenteric artery (Murata et al, 2002) and anti-inflammatory effects (Hayakawa et al, 1999a).…”

Section: Introductionmentioning

confidence: 99%

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Effects of Dai-kenchu-to on spontaneous activity in the mouse small intestine

Kito

Suzuki

2006

J. Smooth Muscle Res.

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The effects of Dai-kenchu-to (DKT), a Chinese medicine, on spontaneous activity of mouse small intestine were investigated. Experiments were carried out with tension recording and intracellular recording. DKT contracted mouse longitudinal smooth muscles in a dose dependent manner (0.1-10 mg/ml). Low concentration of DKT (0.1 mg/ml) did not contract the longitudinal muscles of mouse small intestine. DKT (0.1 mg/ml) inhibited contraction elicited by transmural nerve stimulation (TNS). DKT (1 mg/ml) evoked relaxation before contraction. The initial relaxation was abolished by N ω -nitro-L-arginine (L-NNA). DKT (10 mg/ml)-induced contraction had two components: a transient rapid contraction and a following slow contraction. Atropine inhibited DKT (1 mg/ml)-induced contraction to about 50% of control. In the presence of atropine, tetrodotoxin (TTX) inhibited the contraction elicited by DKT (1 mg/ml) to about 80%. DKT depolarized the membrane and decreased the amplitude of pacemaker potentials recorded from in situ myenteric interstitial cells of Cajal (ICC-MY) with no alteration to the frequency, duration and maximum rates of rise in the presence of nifedipine and TTX.The same results were obtained in slow waves recorded from circular smooth muscle cells. These results indicate that DKT evoked both contraction and relaxation by releasing acetylcholine, nitric oxide and other excitatory neurotransmitters in mouse small intestine. DKT had no effects on pacemaker mechanisms and electrical coupling between ICC-MY and smooth muscle cells in mouse small intestine. The results also suggest that DKT may contract smooth muscles by depolarizing the membrane directly.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effects of Dai-kenchu-to on spontaneous activity in the mouse small intestine

Kito

Suzuki

2006

J. Smooth Muscle Res.

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“…Second, it was also reported that the jejunal J pouch serves as a functional reflux barrier and food reservoir. [18][19][20][21] In addition, the function of the food reservoir leads to a slow food transit time and prevents EDS. Miyoshi et al suggested that pouch reconstruction has the advantage of leading to a more favourable eating capacity to prevent microgastria and fewer postoperative symptoms, including loss of appetite, ARE and EDS.…”

Section: Discussionmentioning

confidence: 99%

Lower oesophageal sphincter‐preserving Roux‐en‐Y esophagojejunostomy with a jejunal J‐pouch reconstruction‐added His angle formation after total gastrectomy in patients with gastric cancer

Tomita

2018

Surgical Practice

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Aim:The aim of the present study was to prevent post-gastrectomy disorders (PGD), such as alkaline reflux esophagitis (ARE), early dumping syndrome (EDS) and microgastria, in patients after total gastrectomy for advanced gastric cancer. We performed lower oesophageal sphincter (LES)-preserving Roux-en Y with jejunal J-pouch reconstruction and His angle formation (LRYJPH). We introduce the application criteria, technical points and results of the LRYJPH procedure. Patients and Methods: Twenty-eight patients who underwent LRYJPH in our hospital from October 2014 to August 2015 were studied. The application criteria were gastric cancer patients (stages II, IIIA and IIIB) who could undergo radical surgery and tumour mainly localized at the middle third of the stomach, with its anal side 5.5 cm or further from the esophagogastric mucosa junction. To preserve the LES, the abdominal oesophagus was resected at the level of the His angle. To make a jejeunal J pouch, a plicated jejunal loop of 15 cm in length was made. After end-to-side esophagojejunostomy of the jejunal J pouch, a His angle was created on the left-side abdominal oesophagus. Results: The patient's appetite was unchanged compared with before the operation. Symptomatic and endoscopic ARE, food stasis in the jejunal J pouch and microgastria were all absent. EDS was 8.3 per cent. The level of satisfaction after the operation was 100 per cent. Conclusion: LRYJPH is appropriate to prevent PGD. This procedure is safe and facilities satisfactory results.

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“…Several studies have demonstrated that DKT enhances GI motility both in vitro (7,8) and in vivo (6,9,10), as well as increasing intestinal blood flow (2, 11), reducing the blood ammonia level after hepatectomy (12), and exerting anti-inflammatory effects (13,14). Similarly, recent clinical studies have demonstrated that DKT improves not only GI motility after surgery (15,16) but also attenuates the progression of adhesional bowel obstruction due to abdominal surgery (17,18).…”

Section: Abstract Aim: Although It Has Been Widely Demonstrated Thatmentioning

confidence: 99%

Perioperative Administration of Traditional Japanese Herbal Medicine Daikenchuto Relieves Postoperative Ileus in Patients Undergoing Surgery for Gastrointestinal Cancer: A Systematic Review and Meta-analysis

Ishizuka

Shibuya

Nagata

et al. 2017

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Abstract. Aim: Although it has been widely demonstrated that administration of Daikenchuto (DKT), a traditional Japanese herbal medicine, improves gastrointestinal (GI) motility in patients undergoing abdominal surgery, few studies have investigated the efficacy of perioperative DKT administration for relief of postoperative ileus (PI) in patients undergoingDaikenchuto (DKT) is a well-known traditional Japanese herbal (kampo) medicine for improvement of gastrointestinal (GI) function (1-4). DKT extract powder is manufactured from an aqueous extract containing 2.2% Japanese pepper, 5.6% processed ginger, 3.3% ginseng radix, and 88.9% maltose syrup powder derived from rice (Tsumura & Co., Tokyo, Japan) (3). Because the medicinal effects of DKT have been established through a delicate balance of these three herbal ingredients over many centuries, DKT has not yet been fully accepted by all modern physicians, including those in both eastern (5) and western countries.However, over the past decade, basic studies using animal models have revealed that the effects of DKT on GI function are mediated by cholinergic and serotonergic nerves (6). Several studies have demonstrated that DKT enhances GI motility both in vitro (7,8) and in vivo (6, 9, 10), as well as increasing intestinal blood flow (2, 11), reducing the blood ammonia level after hepatectomy (12), and exerting anti-inflammatory effects (13,14). Similarly, recent clinical studies have demonstrated that DKT improves not only GI motility after surgery (15, 16) but also attenuates the progression of adhesional bowel obstruction due to abdominal surgery (17,18).Although several randomized controlled trials (RCTs) have confirmed the effects of DKT (19), previously demonstrated in animal models (13,20), for improving postoperative GI motility in patients undergoing abdominal surgery (21-25), few studies have investigated whether DKT reduces the occurrence of postoperative ileus (PI) in patients undergoing surgery for GI cancer as a primary end-point. Therefore, it seems reasonable to assume that, if DKT 5967

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Dai-kenchu-to, a Chinese herbal medicine, improves stasis of patients with total gastrectomy and jejunal pouch interposition

Cited by 75 publications

References 16 publications

Effects of Dai-kenchu-to on spontaneous activity in the mouse small intestine

Effects of Dai-kenchu-to on spontaneous activity in the mouse small intestine

Lower oesophageal sphincter‐preserving Roux‐en‐Y esophagojejunostomy with a jejunal J‐pouch reconstruction‐added His angle formation after total gastrectomy in patients with gastric cancer

Perioperative Administration of Traditional Japanese Herbal Medicine Daikenchuto Relieves Postoperative Ileus in Patients Undergoing Surgery for Gastrointestinal Cancer: A Systematic Review and Meta-analysis

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