| Title : PyRICo-Pilot - Pyridostigmine to reduce the duration of postoperative ileus after colorectal surgery - a phase II study - Dudi-Venkata_2021_Colorectal.Dis__ |
| Author(s) : Dudi-Venkata NN , Kroon HM , Bedrikovetski S , Traeger L , Lewis M , Lawrence MJ , Hunter RA , Moore JW , Thomas ML , Sammour T |
| Ref : Colorectal Dis , : , 2021 |
| Abstract : AIM: Postoperative ileus (POI) is a major problem after colorectal surgery. Acetylcholinesterase inhibitors (ACEI) like pyridostigmine increase gastro-intestinal (GI) motility through a cholinergic anti-inflammatory pathway (CAIP). The purpose of this phase II pilot study is to determine the safety of oral pyridostigmine after elective colorectal surgery. METHODS: This is a stage 2b safety study (IDEAL framework). All adult patients undergoing elective colorectal resections or formation or reversal of stoma at the Royal Adelaide Hospital between September 2020 and January 2021 were eligible. The primary outcomes were 30-day postoperative complications, reported adverse events and GI-2: a validated composite outcome measure of recovery of GI function after surgery defined as the interval from surgery until first passage of stool and tolerance of a solid intake for 24 hrs (in whole days) in the absence of vomiting. RESULTS: Fifteen patients were included in the study. The median age was 58 (50-82) years, and seven (47%) were men. Most participants had an ASA grade <= II (53%), and the median BMI was 27 (24-35). There were 13 postoperative complications (seven were Clavien-Dindo (CD) 1, five CD 2, and one CD 3). None appeared directly related to pyridostigmine administration, and none of the patients had any overt symptoms of excessive parasympathetic activity. Median GI-2 was two days (1-4). CONCLUSION: Oral pyridostigmine appears to be safe to use after elective colorectal surgery in a select group of patients. However, considering this is a pilot study with a small sample size, larger controlled studies are needed to confirm this finding and establish efficacy for POI prevention. |
| ESTHER : Dudi-Venkata_2021_Colorectal.Dis__ |
| PubMedSearch : Dudi-Venkata_2021_Colorectal.Dis__ |
| PubMedID: 34021689 |
Dudi-Venkata NN, Kroon HM, Bedrikovetski S, Traeger L, Lewis M, Lawrence MJ, Hunter RA, Moore JW, Thomas ML, Sammour T (2021)
PyRICo-Pilot - Pyridostigmine to reduce the duration of postoperative ileus after colorectal surgery - a phase II study
Colorectal Dis
:
Dudi-Venkata NN, Kroon HM, Bedrikovetski S, Traeger L, Lewis M, Lawrence MJ, Hunter RA, Moore JW, Thomas ML, Sammour T (2021)
Colorectal Dis
: