Published online Aug 26, 2016. doi: 10.13105/wjma.v4.i4.88
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
To assess the effectiveness of Daikenchuto for patients with postoperative adhesive small bowel obstruction (ASBO).
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.
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.
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.