Significance of daikenchuto administration for postoperative ileus in robot-assisted radical cystectomy and intracorporeal urinary diversion

: Purpose : Postoperative ileus is a common complication following robot-assisted radical cystectomy with urinary diversion using the small intestine. Daikenchuto, an oral medication, has been identified as a potential agent to promote intestinal motility. However, its efficacy in preventing ileus after robot-assisted cystectomy with intracorporeal urinary diversion remains unclear. Methods : This study analyzed patients who underwent robot-assisted radical cystectomy with intracorporeal urinary diversion using the small intestine at Gifu University between November 2018 and May 2025. Patients who received perioperative Daikenchuto (TU-100, 7.5 g/day) from the day of hospital admission until discharge were assigned to Group I, whereas those who did not receive TU-100 were assigned to Group II. Patient backgrounds were adjusted using propensity score matching, and comparative analysis was performed. Results : A total of 145 patients were included in the final analysis. Following propensity score matching, 42 cases were allocated to each group. No significant differences were observed between both groups regarding length of hospital stay, postoperative ileus incidence rate, or duration from ileus onset to recovery. Conclusion : The effectiveness of Daikenchuto may be constrained in patients who have undergone robot-assisted radical cystectomy with intracorporeal urinary diversion using the small intestine.