Effects of Saireito (TJ-114), a traditional Japanese herbal medicine, on high-output syndrome after the creation of a temporary ileostomy in rectal cancer surgery

Purpose: In rectal cancer surgery, a temporary ileostomy is often created to prevent clinical anastomotic leakage. However, high-output syndrome (HOS) frequently arises as a postoperative complication. We aimed to investigate the preventive effect of Saireito, a traditional Japanese herbal medicine, on HOS in patients with a temporary ileostomy. Methods: At our institution, Saireito has been routinely administered to patients undergoing rectal cancer surgery with temporary ileostomy since October 2022. Patients received 9 g / day of Saireito in three divided doses starting from the afternoon of postoperative day 1 (POD1). After excluding eight patients who discontinued Saireito or took it for less than 5 days, 63 patients were analyzed. HOS was defined as a stoma output exceeding 1,500 mL / day by POD10. Patients were divided into two groups: the Saireito group (≥ 5 days of Saireito, n = 37) and the control group (no Saireito, n = 26), and the incidence of HOS was compared. Result : There were no significant differences in patient background characteristics between the two groups (p > 0.05). HOS occurred in 13 patients (20.6%). The incidence of HOS was significantly lower in the Saireito group (4 / 37, 10.8%) compared to the control group (9 / 26, 34.6%) (p = 0.0291). Conclusion: Postoperative administration of Saireito in rectal cancer patients with temporary ileostomy was associated with a reduced incidence of high-output syndrome. Saireito may be a promising option for preventing HOS in such cases.