Ukai T, Shikata S, Kassai R, Takemura Y. Daikenchuto for postoperative adhesive small bowel obstruction: A systematic review and meta-analysis. World J Meta-Anal 2016; 4(4): 88-94 [DOI: 10.13105/wjma.v4.i4.88]
Corresponding Author of This Article
Satoru Shikata, MD, PhD, Department of Family Medicine, Mie University School of Medicine and Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie 515-3133, Japan. shikata-s@umin.org
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Meta-Analysis
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Tomohiko Ukai, Department of Community Medicine, Mie University School of Medicine, Mie 515-3133, Japan
Satoru Shikata, Yousuke Takemura, Department of Family Medicine, Mie University School of Medicine and Graduate School of Medicine, Mie 515-3133, Japan
Ryuki Kassai, Department of Community and Family Medicine, Fukushima Medical University, Fukushima 960-1295, Japan
Author contributions: Ukai T contributed to the study design, literature search and selection, data extraction and analysis, and writing the draft; Shikata S and Takemura Y participated in the literature search and selections, data extraction and analysis; Kassai R contributed to the preparation of the manuscript and critically revised the manuscript for intellectual content; all authors read and approved the final manuscript.
Conflict-of-interest statement: The authors deny any conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Satoru Shikata, MD, PhD, Department of Family Medicine, Mie University School of Medicine and Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie 515-3133, Japan. shikata-s@umin.org
Telephone: +81-59-2315290 Fax: +81-59-2315289
Received: February 24, 2016 Peer-review started: February 25, 2016 First decision: April 11, 2016 Revised: May 22, 2016 Accepted: June 14, 2016 Article in press: June 16, 2016 Published online: August 26, 2016 Processing time: 184 Days and 5.3 Hours
Abstract
AIM
To assess the effectiveness of Daikenchuto for patients with postoperative adhesive small bowel obstruction (ASBO).
METHODS
A systematic search of PubMed (MEDLINE), CINAHL, the Cochrane Library and Ichushi Web was conducted, and the reference lists of review articles were hand-searched. The outcomes of interest were the incidence rate of surgery, the length of hospital days and mortality. The quality of the included studies, publication bias and between-study heterogeneity were also assessed.
RESULTS
Three randomized controlled trials (RCTs) and three retrospective cohort studies were selected for analysis. In the three RCTs, Daikenchuto significantly reduced the incidence of surgery (pOR = 0.13; 95%CI: 0.03-0.50). Similarly, Daikenchuto significantly reduced the incidence of surgery (pOR = 0.53; 95%CI: 0.32-0.87) in the three cohort studies. The length of hospital stay and mortality were not measured or described consistently.
CONCLUSION
The present meta-analysis demonstrates that administering Daikenchuto is associated with a lower incidence of surgery for patients with postoperative ASBO in the Japanese population. In order to better generalize these results, additional studies will be needed.
Core tip: Daikenchuto, a traditional herbal medicine, is commonly used by gastroenterologists for postoperative adhesive small bowel obstruction in Japan. However, the effectiveness of Daikenchuto has not been systemically investigated. The systematic review and meta-analysis demonstrated that Daikenchuto is associated with a lower incidence of surgery for patients with postoperative adhesive bowel obstruction in the Japanese population.
