title: Feasibility study on the effectiveness of Goreisan-based Kampo therapy for lower abdominal lymphedema after retroperitoneal lymphadenectomy via extraperitoneal approach.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of Kampo therapy based on Goreisan for lower abdominal lymphedema after surgical treatment of endometrial cancer or cervical cancer.
  
  
  METHODS
  Radical surgery, including retroperitoneal lymphadenectomy, was performed for endometrial cancer and cervical cancer. After surgery, Kampo therapy based on Goreisan and integrated physical therapy were provided for patients with lower abdominal lymphedema, especially lymphedema affecting the pubic-inguinal-vulval region. Goreisan (7.5 g/day) was given orally three times a day (tds). If a significant response was not observed, Saireito (9 g/day; 3 g tds) or Gosyajinkigan (7.5 g/day; 2.5 g tds) was administered concomitantly.
  
  
  RESULTS
  A total of 21 patients received treatment. The response rate to Goreisan monotherapy was 78%, with 22% being non-responders. Median reduction of abdominal circumference was 2.1cm (95% CI 1.3-2.85). When Goreisan was combined with another Kampo agent, the response rate was 92% and the non-response rate was 8%. The median reduction of the abdominal circumference was 2.85 cm (95% CI: 2.25-3.3). In particular, concomitant Goreisan and Saireito therapy achieved satisfactory results. No severe adverse reactions occurred.
  
  
  CONCLUSIONS
  Goreisan-based Kampo therapy might be effective and safe for lower abdominal lymphedema after retroperitoneal lymphadenectomy. We will perform a prospective control study in the near future.
authors.affiliation: Department of Gynecology, Toho University Ohashi Medical Center, Tokyo, Japan.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Komiyama
authors.affiliation: Department of Gynecology, Toho University Ohashi Medical Center, Tokyo, Japan.
authors.forename: Chiaki
authors.initials: C
authors.lastname: Takeya
authors.affiliation: Department of Gynecology, Toho University Ohashi Medical Center, Tokyo, Japan.
authors.forename: Rena
authors.initials: R
authors.lastname: Takahashi
authors.affiliation: Department of Gynecology, Toho University Ohashi Medical Center, Tokyo, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Yamamoto
authors.affiliation: Department of Gynecology, Toho University Ohashi Medical Center, Tokyo, Japan.
authors.forename: Kaneyuki
authors.initials: K
authors.lastname: Kubushiro
mesh_terms: D000328:Adult; D004322:Drainage; D016889:Endometrial Neoplasms / Q000601:surgery; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008197:Lymph Node Excision / Q000009:adverse effects* / Q000379:methods; D008209:Lymphedema / Q000209:etiology / Q000628:therapy*; D008516:Medicine, Chinese Traditional / Q000379:methods*; D020835:Medicine, Kampo / Q000379:methods*; D008875:Middle Aged; D026741:Physical Therapy Modalities; D011183:Postoperative Complications / Q000209:etiology / Q000628:therapy*; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000601:surgery
keywords: Goreisan; Kampo; lower abdominal lymphedema; retroperitoneal lymphadenectomy; uterine cancer