Smart Christopher J, Malik Kamran I
a East Cheshire NHS Trust , Macclesfield , UK.
Expert Opin Investig Drugs. 2017 Apr;26(4):489-493. doi: 10.1080/13543784.2017.1301427. Epub 2017 Mar 10.
Postoperative ileus (POI) is an impairment of coordinated gastrointestinal (GI) motility that develops as a consequence of abdominal surgery and is a major factor contributing to patient morbidity and prolonged hospitalisation. Despite the availability of various options its treatment is still under debate. This review will focus on effect of Prucalopride (5-HT receptor agonist) on postoperative ileus based on the existing literature. Areas covered: A literature search of MEDLINE, EMBASE and COCHRANE Library was performed concerning topics related to the treatment of ileus with prucalopride. The search strategy also included articles relating to other treatments of ileus for comparison with prucalopride. Expert opinion: Postoperative ileus remains difficult to treat and most strategies encompass preventative measures through enhanced recovery after surgery and laparoscopic approaches. The role of pharmacological intervention is developing with some drugs licensed for use. The evidence for prucalopride remains unclear although there is randomised controlled trial (RCT) evidence available. Given the potential for reduction in patient morbidity and length of stay the role of prucalopride in POI should be further investigated with multi-centre RCTs to establish which group of patients will gain the most from this exciting potential treatment.
术后肠梗阻(POI)是腹部手术后出现的胃肠(GI)协调性运动障碍,是导致患者发病和住院时间延长的主要因素。尽管有多种治疗选择,但对其治疗仍存在争议。本综述将基于现有文献重点探讨普芦卡必利(5-羟色胺受体激动剂)对术后肠梗阻的影响。涵盖领域:对MEDLINE、EMBASE和Cochrane图书馆进行了文献检索,主题涉及普芦卡必利治疗肠梗阻。检索策略还包括与肠梗阻其他治疗方法相关的文章,以便与普芦卡必利进行比较。专家观点:术后肠梗阻仍然难以治疗,大多数策略包括通过术后加速康复和腹腔镜手术方法采取预防措施。随着一些药物获得许可使用,药物干预的作用正在发展。尽管有随机对照试验(RCT)证据,但普芦卡必利的证据仍不明确。鉴于有可能降低患者发病率和缩短住院时间,应通过多中心RCT进一步研究普芦卡必利在POI中的作用,以确定哪一组患者将从这种有前景的潜在治疗中获益最多。