Surgery · Medical Literature
[Efficiency of serotonin in the prevention of postoperative ileus in patients after robot-assisted radical prostatectomy].
Abstract
Postoperative ileus is a transient impairment of gastrointestinal motility that occurs after surgery and anesthesia. Currently, there is a sustained trend toward investigating the role of serotonin as a regulator of intestinal motor function. To evaluate the clinical efficiency of serotonin (Dinaton) in the prevention of postoperative ileus, pain severity, and hemostasis parameters in patients after robot-assisted radical prostatectomy (RARP). A single-center prospective randomized controlled clinical study was conducted and included 70 patients after RARP. In the postoperative period, patients were divided into two groups: the main group and the control group. Patients in the main group received Dinaton in accordance with the official prescribing information. Assessment time points were 10, 24, 48, and 72 hours after surgery. Clinically, patients were evaluated using the VAS (visual analogue scale) and VAS-BLOAT scales. Laboratory assessment included serial measurements of C-reactive protein (CRP) and serum hemoglobin. Drain output volume and the occurrence of defecation were also recorded. In the group receiving Dinaton, a significant decrease in CRP was observed at 48 hours (=0,00011). No significant differences were found between the main and control groups in hemoglobin levels or drain output volume (p>0,05). According to the VAS, significantly lower postoperative pain intensity persisted throughout the 72-hour period in the main group, along with a reduced need for analgesics compared with the control group. Abdominal bloating was less pronounced in the Dinaton group (VAS-BLOAT) over three days (p<0,05). Use of serotonin in urological patients after RARP significantly reduced pain intensity and abdominal bloating and decreased CRP levels, indicating a more rapid normalization of the systemic inflammatory response.
Clinical relevance
Does perioperative administration of serotonin adipate (Dinaton) reduce postoperative ileus, pain severity, and inflammatory markers in patients undergoing robot-assisted radical prostatectomy (RARP) compared with standard postoperative care? __SNAPSHOT__ {"studyDesign":"Single-center prospective randomized controlled clinical trial","setting":"Single center; country not specified in abstract (journal is Russian; presumed Russia)","sampleSize":"n=70 (intervention [Dinaton]: not reported per group; control: not reported per group — equal allocation implied but not confirmed)","population":"Adult male patients who underwent robot-assisted radical prostatectomy (RARP); specific inclusion/exclusion criteria, age range, comorbidities, ASA class, and prostate cancer staging not reported in abstract","intervention":"Serotonin adipate (Dinaton) administered postoperatively per official prescribing information; specific dose, route, frequency, and duration not reported in abstract","comparator":"Control group receiving standard postoperative care (exact components not defined in abstract)","primaryOutcome":"Not explicitly designated as a single primary endpoint; outcomes assessed included: CRP at 10, 24, 48, and 72 hours postoperatively; pain severity via VAS; bloating via VAS-BLOAT; serum hemoglobin; drain output volume; and occurrence of defecation","followUp":"72 hours postoperatively","fundingSource":"Not reported"}
Key findings
The abstract reports a statistically significant reduction in CRP in the Dinaton group at 48 hours postoperatively; the exact p-value, baseline CRP values, and magnitude of difference are not fully reported in the supplied abstract (the abstract is truncated after '=0,'). No complete quantitative data for the VAS pain score, VAS-BLOAT score, serum hemoglobin, drain output volume, or time-to-defecation are available from the abstract. Absolute risk reduction, relative risk reduction, confidence intervals, and NNT/NNH cannot be calculated from the information provided. No adverse event data, safety signals, or hemostasis complications are reported in the abstract. All numerical results beyond the partial CRP finding at 48 hours are not reported.
Practice implications
Based solely on the available abstract, this study suggests a possible anti-inflammatory benefit of postoperative serotonin adipate (Dinaton) in the RARP setting, as reflected by a statistically significant CRP reduction at 48 hours. However, the abstract is truncated and does not report complete results for any outcome, including the direction and magnitude of CRP change, pain scores, bloating, hemoglobin, drain output, or bowel function recovery. It is therefore not possible to determine whether the observed CRP reduction is clinically meaningful, whether gastrointestinal motility recovery (the central clinical question) was actually improved, or whether any patient-important benefits or harms were demonstrated. The study population is limited to male patients undergoing RARP, so findings cannot be generalized to women, other surgical populations, or more complex abdominal procedures. A 72-hour observation window is short and does not capture outcomes beyond early hospitalization. This analysis is limited to abstract-only data; the full-text article may contain additional results not summarized here. __LIMITATIONS__ Abstract is truncated — key quantitative results for all outcomes are unavailable, precluding full appraisal.,Small sample size (n=70 total) — likely underpowered for rare outcomes such as clinically overt postoperative ileus in a minimally invasive surgical population.,No clearly defined single primary outcome — multiple endpoints (CRP, VAS, VAS-BLOAT, hemoglobin, drain output, defecation) increase risk of type I error without correction for multiplicity.,Short follow-up of 72 hours — does not capture subsequent bowel dysfunction, readmissions, or longer-term safety.,CRP is a surrogate biomarker of inflammation; its reduction does not directly establish a clinically meaningful reduction in postoperative ileus incidence, length of stay, or patient-reported recovery.,Blinding status not reported — unblinded assessment of patient-reported VAS scores may introduce performance and detection bias.,Single-center design limits generalizability across institutions and healthcare systems.,Dosing regimen, route, and duration of Dinaton administration not described, hampering reproducibility.,Funding source not reported — potential for undisclosed conflicts of interest cannot be excluded.,Baseline group characteristics and randomization method not described in abstract, making it impossible to assess comparability or allocation concealment. __BOTTOM_LINE_CATEGORY__ promising_but_preliminary __BOTTOM_LINE__ This small single-center RCT (n=70) reports a statistically significant reduction in CRP at 48 hours in post-RARP patients receiving serotonin adipate (Dinaton), but the abstract is truncated and provides no complete data on clinical outcomes including bowel function recovery, pain, or hemostasis. The evidence is insufficient to support a change in clinical practice; replication in adequately powered, double-blind, multicenter trials with patient-important outcomes is required before Dinaton can be recommended for routine postoperative ileus prophylaxis in urologic surgery.