Mosapride Citrate Improves Postoperative Ileus of Patients with Colectomy

Toyomasu, Yoshitaka; Mochiki, Erito; Morita, Hiroki; Ogawa, Atsushi; Yanai, Mitsuhiro; Ohno, Tetsuro; Fujii, Takaaki; Tsutsumi, Soichi; Asao, Takayuki; Kuwano, Hiroyuki

doi:10.1007/s11605-011-1567-x

Cited by 35 publications

(23 citation statements)

References 13 publications

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“…magnesium oxide, did not show any beneficial effects in ERAS in a recent randomized study [76]. Mosapride citrate, a 5-HT4R, reduced the occurrence of POI in a clinical study [77]. …”

Section: Resultsmentioning

confidence: 99%

Fast-Track Surgery – Conditions and Challenges in Postsurgical Treatment: A Review of Elements of Translational Research in Enhanced Recovery after Surgery

Hoffmann¹,

Kettelhack²

2012

Eur Surg Res

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Background: Enhanced recovery after surgery (ERAS) or fast-track surgery is a perioperative and postoperative care concept initiated in the early 1990s aiming to reduce the length of hospital stays following elective abdominal surgery. Twenty treatment items defined in the Consensus Guidelines established in 2009 were included in this concept. The success of ERAS depends highly on multidisciplinary teamwork and patient compliance. Several ERAS items and their impact on perioperative and postoperative care have recently been discussed. In this connection, translational research topics triggered increasing interest in ERAS and new impulses aimed at improving the ERAS concept. We thus reviewed the surgical literature to highlight the role of translational research items in ERAS. Methods: A literature search of Medline®, PubMed® and the Cochrane Database was performed. Two investigators independently reviewed the abstracts and appropriate articles were included in this review. Results: Articles have been selected. The advantages of the ERAS concept over conventional postoperative care were established by four meta-analyses and several reviews. But, due to the lack of standardization of the protocols, the level of evidence is still low. The implementation of ERAS into clinical practice is furthermore hampered by the poor compliance with ERAS protocols and remains a challenge for the future. Moreover, recent trials challenge the role of some ERAS items, e.g. epidural anesthesia. Translational research trials investigating stress, immune and inflammatory response after surgery, new analgesic concepts, goal-directed fluid therapy and new drugs and substances to improve the outcome of ERAS provide first promising data but still need to be integrated in the ERAS concept. Conclusion: The Consensus Guidelines for ERAS are subject to the constant evolution of treatment strategies and implementation of translational research findings. Improvement of the compliance with ERAS protocols in surgical clinics and updating of ERAS items taking into account recent findings in translational research may improve the outcomes of ERAS but remain a long-term challenge in surgery for the next years.

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“…magnesium oxide, did not show any beneficial effects in ERAS in a recent randomized study [76]. Mosapride citrate, a 5-HT4R, reduced the occurrence of POI in a clinical study [77]. …”

Section: Resultsmentioning

confidence: 99%

Fast-Track Surgery – Conditions and Challenges in Postsurgical Treatment: A Review of Elements of Translational Research in Enhanced Recovery after Surgery

Hoffmann¹,

Kettelhack²

2012

Eur Surg Res

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“…18 Importantly, these medications are used to treat POI as well as chronic constipation, even though cisapride was withdrawn from the market for cardiovascular safety reasons. [19][20][21] The highly selective 5-hydroxytryptamine receptor 4 agonist, prucalopride, has been indicated for the treatment of chronic constipation, especially in patients who do not experience adequate relief with laxatives. 22 In a phase II trial for POI, 317 patients who underwent partial colectomy were administered 0.5-, 2-, or 4-mg prucalopride once daily until the third day post-surgery.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Postoperative Ileus Following Orthopedic Surgery: The Role of Chronic Constipation

Lee¹,

Lee²,

Hong³

et al. 2015

J Neurogastroenterol Motil

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Background/Aims Distinction is vague between severe constipation and postoperative ileus (POI) in terms of pathogenesis, clinical features, and treatment options. However, no data are available regarding their associations. Methods After retrospective review of data from patients who underwent orthopedic surgery during the first 6 months of 2011, a total of 612 patients were included. Severe constipation was defined as symptoms of constipation requiring treatment using at least 2 laxatives from different classes for at least 6 months. POI was defined as paralytic ileus lasting more than 3 days post-surgery and associated with 2 or more of the following: (1) nausea/vomiting, (2) inability to tolerate an oral diet over a 24-hour period, and (3) absence of flatus over a 24-hour period. The subjects were divided into non-POI and POI groups, and we compared patient-, surgery-, and pharmaceutical-related factors. Results Thirteen (2.1%) out of 612 experienced POI. In comparisons between the non-POI and POI groups, univariate analysis showed significant differences in the mean age (51.4 vs 71.6 years), mean body mass index (24.1 vs 21.8 kg/m 2 ), severe constipation (5.8% vs 76.9%), co-morbidities (33.2% vs 84.6%), type of orthopedic surgery (spine/hip/limb: 19.4/11.0/65.6% vs 23.1/61.5/15.4%), and estimated blood loss (50 vs 300 mL). Multivariate logistic regression analysis, after adjustment for age, body mass index, co-morbidities, type of orthopedic surgery, and estimated blood loss, showed that severe constipation was an independent risk factor for POI (OR, 35.23; 95% CI, 7.72–160.82; P < 0.001). Conclusions Severe constipation is associated with POI after orthopedic surgery.

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“…Alvimopan, a peripherally acting μ‐opioid antagonist, is used for the management of POI . Additionally, mosapride (a 5‐hydroxytryptamine receptor 4 agonist) and daikenchuto (a traditional Japanese herbal medicine) are also reported to prevent POI . The main targets of these drugs are ENS and SMC; however, our evidence indicates that total care for the GI network, including ENS, SMC and ICC, is needed to manage POI.…”

Section: Discussionmentioning

confidence: 90%

Disruption of the pacemaker activity of interstitial cells of Cajal via nitric oxide contributes to postoperative ileus

Kaji

Nakayama

Horiguchi

et al. 2018

Neurogastroenterology Motil

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Mosapride Citrate Improves Postoperative Ileus of Patients with Colectomy

Abstract: Mosapride citrate reduces the duration of postoperative ileus and may improve outcomes after gastrointestinal surgery.

Cited by 35 publications

References 13 publications

Fast-Track Surgery – Conditions and Challenges in Postsurgical Treatment: A Review of Elements of Translational Research in Enhanced Recovery after Surgery

Fast-Track Surgery – Conditions and Challenges in Postsurgical Treatment: A Review of Elements of Translational Research in Enhanced Recovery after Surgery

Risk Factors for Postoperative Ileus Following Orthopedic Surgery: The Role of Chronic Constipation

Disruption of the pacemaker activity of interstitial cells of Cajal via nitric oxide contributes to postoperative ileus

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