A Phase II, Randomized, Controlled Trial of Acupuncture for Reduction of Postcolectomy Ileus

Abstract

Purpose. Postoperative ileus (POI) prolongs hospital stay and increases risk of postoperative complications. We conducted a randomized, sham-controlled trial to evaluate whether acupuncture reduces POI more effectively than sham acupuncture. Methods. Colon cancer patients undergoing elective colectomy were randomized to receive 30 min of true or sham acupuncture twice daily during their first 3 postoperative days. GI-3 (the later of the following two events: time that the patient first tolerated solid food, AND time that the patient first passed flatus OR a bowel movement) and GI-2 (the later of the following two events: time patient first tolerated solid food AND time patient first passed a bowel movement) were determined. Pain, nausea, vomiting, and use of pain medications were evaluated daily for the first 3 postoperative days. Results. Ninety patients were randomized. Eighty-one received the allocated intervention: 39 in the true acupuncture group and 42 in the sham acupuncture group, all evaluated for the primary endpoint. The mean time to GI-3 was 149 h [standard deviation (SD) 71 h] and 146 (SD 62 h) after surgery for the acupuncture group and the sham acupuncture group (difference between means −2 h; 95 % confidence interval −31, 26; p = 0.9). No significant differences were found between groups for secondary endpoints. Conclusions. True acupuncture as provided in this study did not reduce POI more significantly than sham acupuncture. The study was limited by a standard deviation much larger than expected, suggesting that a study with a larger sample size might be required.

Incidence of prolonged postoperative ileus after colorectal surgery: a systematic review and meta‐analysis

“…In total, 54 publications were included with a total number of 18 983 patients. Seventeen studies were RCTs [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33], four were case-control studies [34][35][36][37], nine were prospective studies [5,[38][39][40][41][42][43][44][45] and 24 were retrospective studies . The methodological quality of the included studies is shown in Tables 1 and 2.…”

Effect of Acupuncture on Reducing Duration of Postoperative Ileus After Gastrectomy in Patients with Gastric Cancer: A Pilot Study Using Sitz Marker

“…Meng et al 25 randomly assigned 90 patients with prolonged POI to receive electroacupuncture or no acupuncture after surgery but failed to show significant differences between the two groups. Deng et al 26 randomly assigned 81 patients to receive electroacupuncture or sham acupuncture after colonic surgery, but electroacupuncture did not reduce POI compared with sham acupuncture. Ng et al 5 randomly assigned 165 patients who underwent elective laparoscopic surgery for colon cancer to receive electroacupuncture, sham, or no acupuncture after.…”

Effect and Mechanism of Acupuncture on Gastrointestinal Diseases

“…Acupuncture has been used for treating various gastrointestinal (GI) diseases, including functional dyspepsia (Diehl, 1999;Ma et al, 2012;Xu et al, 2006), irritable bowel syndrome (IBS) (Chan, Carr, & Maberry, 1997;Chey, Maneerattaporn, & Saad, 2011;Fireman, Segal, Kopelman, Sternberg, & Carasso, 2001;Schneider et al, 2006), diabetic gastroparesis (Chang, Ko, Wu, & Chen, 2001;Wang, 2004;Yin, Chen, & Chen, 2010), constipation (Broide et al, 2001;van Wunnik, Baeten, & Southwell, 2011;Zhu, Li, Chen, Wang, & Kan, 2003), diarrhea (Anastasi & McMahon, 2003;Burgmann, Rawsthorne, & Bernstein, 2004), postoperative ileus (Balestrini, Tsuchida, Fukuda, Pappas, & Takahashi, 2005;Deng et al, 2013;Ng et al, 2013), and visceral hypersensitivity (Chu et al, 2012;Tian et al, 2006;Xu, Winston, & Chen, 2009). …”