The Effect of Prucalopride Succinate on Gastrointestinal Motility After Laparoscopic Gastrectomy : Prospective Double Blind Case-control Study
Condition: Gastric Cancer
MeSH terms: Stomach Neoplasms
Study type: Interventional

Summary: 
      In order to improve postoperative ileus in patients undergoing gastrointestinal surgery,
      digestive medications and prokinetics have been routinely used. Among them, mosapride citrate
      is widely used as a representative drug, as it is a 5-hydroxytryptamine 4 receptor agonist
      that increases gastrointestinal motility.

      Prucalopride succinate (dihydrobenzofurancarboxamide) is a type of 5-hydroxytryptamine 4
      receptor agonist that has a higher affinity for the 5-HT4 receptor compared to mosapride (a
      benzamide derivative) which belongs to the same class of drugs. Prucalopride succinate has
      been demonstrated to increase both gastric and colonic motility through in vivo and in vitro
      studies. As mentioned earlier, it exhibits high specificity for the 5-HT4 receptor. The 5-HT4
      receptor is not expressed in the gastric mucosa but is expressed at low concentrations in the
      small intestine, whereas it is highly expressed in the colonic mucosa. Therefore,
      prucalopride is widely used as a therapeutic agent for chronic constipation by increasing
      colonic motility. Furthermore, Prucalopride succinate stimulates the 5-HT4 receptors present
      in the nerve terminals of the myenteric plexus, promoting the release of acetylcholine. The
      released acetylcholine acts on α7nAch receptors located on the surface of enteric smooth
      muscle cells, inhibiting inflammatory responses and reducing postoperative ilues.

      A randomized controlled trial (RCT) conducted on 110 patients who underwent gastrointestinal
      surgery demonstrated that prucalopride succinate showed significant improvement in
      gastrointestinal motility compared to the control group. Currently, mosapride citrate is
      widely used as a prokinetic agent in clinical practice. However, preliminary studies have
      shown no significant efficacy, and when comparing abdominal X-ray images taken on the third
      day after surgery, there is no significant difference compared to the placebo group. As a
      result, it can be observed that the recovery of gastrointestinal motility after surgery is
      not primarily due to small bowel motility but rather delayed gas passing caused by colon
      motility. Therefore, it can be assumed that using drugs that increase colon motility may be
      effective in improving gastrointestinal motility after surgery.
    


Intervention name(s): Arm I : Experimental (Prucalopride succinate group); Arm II : Control (Mosapride citrate group)
Intervention type(s): Drug; Drug
Intervention description(s): Experimental group taking prucalopride succinate from day 1 to day 5 after surgery; Control gourp taking mosapride citrate from day 1 day 5 after surgery
Intervention MeSH terms: Prucalopride; Mosapride
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Triple (Participant, Care Provider, Investigator)
Primary purpose: Treatment