Effects of Rikkunshito on postgastrectomy weight loss and nutritional status in gastric cancer patients: A retrospective observational study

Postgastrectomy disorders decrease the quality of life of patients because of poor oral intake and nutritional status. Rikkunshito is a Japanese herbal medicine that alleviates anorexia and prevents upper gastrointestinal disorders, particularly in the perioperative period. Herein, we investigated whether Rikkunshito administration in the early perioperative period alleviates weight loss and improves the nutritional status after undergoing minimally invasive distal gastrectomy for gastric cancer. We conducted a retrospective cohort study involving 139 consecutive gastric cancer patients who underwent laparoscopic or robot-assisted distal gastrectomy for potentially curable gastric cancer between January 2018 and May 2023 at our institution. We divided the patients into 2 groups based on Rikkunshito administration time: Rikkunshito administered on postoperative day 4 (RPOD4 group) and on postoperative day 1 (RPOD1 group). We performed one-to-one propensity score matching to balance the baseline characteristics. We examined the postoperative body weight changes and nutritional status at 1 month. One month postoperatively, the RPOD1 group showed a significantly smaller body weight change rate (7.12% [RPOD4] vs 5.35% [RPOD1], P < .05). For nutritional status, the RPOD1 group showed significantly higher prognostic nutritional index score (47.21 ± 16.45 [RPOD4] vs 49.45 ± 5.50 [RPOD1], P < .05) and geriatric nutritional risk index score (97.22 ± 20.49 [RPOD4] vs 100.97 ± 7.96 [RPOD1], P < .05). Initiating rikkunshito in the early perioperative period alleviates weight loss and improves the nutritional status after minimal invasive distal gastrectomy for gastric cancer.