Prucalopride succinate accelerates postoperative intestinal recovery following gastrectomy in a randomized clinical trial

The enhanced recovery after surgery (ERAS) protocol includes prokinetic agents to reduce postoperative ileus. This double-blind, randomized controlled trial enrolled patients scheduled for minimally invasive gastrectomy for gastric cancer. Patients were randomly assigned to receive either mosapride citrate (control) or prucalopride succinate (experimental) from postoperative days 1 to 4. Bowel motility was assessed by tracking radiopaque marker migration on serial abdominal radiographs, along with first-flatus time, food intake, and inflammatory markers. Baseline characteristics were comparable between groups. On postoperative day 5, the percentage of radiopaque markers passed to the colon was significantly higher in the experimental group. (96.90 ± 10.15% vs 90.20 ± 15.29%, p  = 0.012) The neutrophil–lymphocyte ratio was also lower on postoperative day 3 in the experimental group (4.85 ± 2.49 vs 6.02 ± 3.06, p  = 0.035). Prucalopride succinate enhances bowel motility after gastrectomy and may reduce early postoperative inflammation. It may be considered as an adjunct to ERAS protocols in gastric cancer surgery.