Effect of mosapride on recovery of intestinal motility after hand-assisted laparoscopic colectomy for carcinoma.
OBJECTIVE
Mosapride citrate (mosapride) is a serotonin 5-hydroxytryptamine 4 receptor agonist known to promote gastric emptying and large-intestine motility. We assessed the effect of mosapride on postoperative ileus following colon surgery.


METHODS
Forty patients with colon cancer undergoing hand-assisted laparoscopic colectomy were randomly assigned to a mosapride group or a control group. The mosapride group received 15 mg of mosapride by mouth with 50 ml of water three times a day, starting on postoperative day 1. The control group received 50 ml of water on the same schedule. Patients were allowed to resume oral feeding on the evening of postoperative day 2. Postoperative time to first bowel movement was evaluated by one investigator blinded to treatment. Postoperative gastric emptying was evaluated with the [(13)C]-acetate breath test at 24 and 48 hours after the operation.


RESULTS
Postoperative time to first bowel movement was significantly shorter in the mosapride group than in the control group (48.5 vs. 69.3 hours, P = 0.0149). The time to maximal gastric emptying rate as determined by the breath test was significantly shorter in the mosapride group than in the control group at the 48-hour time point (27.9 vs. 35.3 minutes, P = 0.0294). Postoperative hospital stay was shorter in patients receiving mosapride than in controls (6.7 vs. 8.4 days, P = 0.0398). No adverse effects were observed with mosapride.


CONCLUSIONS
Gastric emptying was improved by mosapride. The results suggested that the period of postoperative ileus following hand-assisted laparoscopic colectomy can be shortened by treatment with mosapride.
Narita
Kazuhiro
K
Department of General & Gastroenterological Surgery, Showa University School of Medicine, Shinagawa-ku, Tokyo, 142-8666, Japan. narichan@med.showa-u.ac.jp
Tsunoda
Akira
A
Takenaka
Koji
K
Watanabe
Makoto
M
Nakao
Kentaro
K
Kusano
Mitsuo
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001549:Benzamides / Q000627:therapeutic use*; D002277:Carcinoma / Q000503:physiopathology / Q000628:therapy*; D003082:Colectomy / Q000009:adverse effects; D003110:Colonic Neoplasms / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D005769:Gastrointestinal Motility / Q000502:physiology; D006801:Humans; D045823:Ileus / Q000209:etiology / Q000517:prevention & control; D010535:Laparoscopy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009025:Morpholines / Q000627:therapeutic use*; D020127:Recovery of Function; D017366:Serotonin Receptor Agonists / Q000627:therapeutic use*; D016037:Single-Blind Method
D001549:Benzamides; D009025:Morpholines; D017366:Serotonin Receptor Agonists; C062720:mosapride