A Clinical Study of Rehabilitation with the Herbal Medicine Dai-Kenchu-Tou after Colorectal Operation

Yasuo Kabeshima, Yoko Takahashi, Noriaki Kameyama, Atsushi Toizumi, Yoichiro Tamura and Takahisa Kageyama

Department of Surgery, Kasumigaura Medical Center

Purpose: Herbal medication Dai-Kenchu-Tou is clinically effective in postoperative ileus. We studied the efficacy of rehabilitation with Dai-Kenchu-Tou after colorectal surgery. Patients and methods: Subjects were 98 patients (average age 67.9, male:female=47:51) undergoing a colorectal surgery between 2000 and 2003. We analyzed open surgery (OS) and laparoscopic surgery (LS) separately. Patients were divided into a Dai-Kenchu-Tou (DKT) group (n=24 (OS), n=16 (LS)) and a Traditional group (TRAD) (n=51 (OS), n=7 (LS)). We excluded those with anastomosis leakage and infections. Patients were scheduled to have the NG tube and start drinking on postoperative day (POD) 1. The DKT group was started on Dai-Kenchu-Tou on POD 1 or 2. Liquid was started after first flatus. Every 2 days, we increased diet calorie if no symptoms of ileus or bowel obstruction occurred. Subjects able to intake a 1,200 kcal diet were discharged. Results: In the OS group, age, gender, location, pathological stage, and operative procedure were similar. Significant differences were observed in the time of first flatus (2.4±0.7 days in the DKT group vs. 3.4±1.6 days in the TRAD group; P=0.007) and length of postoperative hospitalization (8.4±1.6 days in the DKT group vs. 12.3±7.1 days in the TRAD group; P=0.009). The incidence of bowel obstruction was 0% in the DKT group vs. 5.8% in the TRAD group. Analysis of variance of postoperative hospitalization showed blood loss (P=0.0002) and Dai-Kenchu-Tou (P=0.0086) to be significant factors. No other factor was significant. In the LS group, no significant difference was seen in the time of first flatus, length of postoperative hospitalization, or the incidence of bowel obstruction. Conclusions: The use of herbal medicine Dai-Kenchu-Tou after colorectal operation under laparotomy is effective and recommended.

Key words
colorectal surgery, hospitalization, rehabilitation, Dai-Kenchu-Tou

Reprint requests
Yasuo Kabeshima Department of Surgery, Kasumigaura Medical Center
2-7-14 Shimotakatsu, Tsuchiura, 300-8585 JAPAN

Accepted
January 26, 2005

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