Transcutaneous electroacupuncture alleviates postoperative ileus after gastrectomy: A randomized clinical trial

Abstract

AIMTo investigate the efficacy and safety of transcutaneous electroacupuncture (TEA) to alleviate postoperative ileus (POI) after gastrectomy.METHODSFrom April 2014 to February 2017, 63 gastric cancer patients were recruited from the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China. After gastrectomy, the patients were randomly allocated to the TEA (n = 33) or control (n = 30) group. The patients in the TEA group received 1 h TEA on Neiguan (ST36) and Zusanli (PC6) twice daily in the morning and afternoon until they passed flatus. The main outcomes were hours to the first flatus or bowel movement, time to nasogastric tube removal, time to liquid and semi-liquid diet, and hospital stay. The secondary outcomes included postoperative symptom assessment and complications.RESULTSTime to first flatus in the TEA group was significantly shorter than in the control group (73.19 ± 15.61 vs 82.82 ± 20.25 h, P = 0.038), especially for open gastrectomy (76.53 ± 14.29 vs 87.23 ± 20.75 h, P = 0.048). Bowel sounds on day 2 in the TEA group were significantly greater than in the control group (2.30 ± 2.61/min vs 1.05 ± 1.26/min, P = 0.017). Time to nasogastric tube removal in the TEA group was earlier than in the control group (4.22 ± 1.01 vs 4.97 ± 1.67 d, P = 0.049), as well as the time to liquid diet (5.0 ± 1.34 vs 5.83 ± 2.10 d, P = 0.039). Hospital stay in the TEA group was significantly shorter than in the control group (8.06 ± 1.75 vs 9.40 ± 3.09 d, P = 0.041). No significant differences in postoperative symptom assessment and complications were found between the groups. There was no severe adverse event related to TEA.CONCLUSIONTEA accelerated bowel movements and alleviated POI after open gastrectomy and shortened hospital stay.

Perioperative Electroacupuncture Can Accelerate the Recovery of Gastrointestinal Function in Cancer Patients Undergoing Pancreatectomy or Gastrectomy: A Randomized Controlled Trial

“…Acupuncture has been used as a minimally invasive and comprehensive treatment for gastrointestinal motility disorders in China for thousands of years. Chen et al [ 7 ] found that transcutaneous electroacupuncture accelerated bowel movements. EA has also been widely accepted by Western clinicians and patients and has become an effective method for the treatment of various gastrointestinal conditions.…”

“…The effect of EA in a previous study on gastrectomy was limited. Chen et al [ 7 ] found that transcutaneous electroacupuncture accelerated bowel movements in patients undergoing open gastrectomy but laparoscopic surgery. Meng et al [ 15 ] conducted a study in 90 patients with prolonged POI who were randomly selected and given electroacupuncture or no acupuncture after the operation.…”

“…Ng et al [ 6 ] found that acupuncture reduced the duration of postoperative ileus after laparoscopic surgery for colorectal cancer. Chen et al [ 7 ] found that transcutaneous electroacupuncture could accelerate bowel movement and alleviate POI after open gastrectomy. However, the experience with acupuncture of patients undergoing pancreatectomy and gastrectomy is limited, and the literature related to this question is rare.…”

Electroacupuncture accelerates the delayed intestinal transit in POI by suppressing M1 like muscularis macrophages and IL6 secretion

“…23 EA was also proved to normalize the impaired colonic motility induced by rectal distension or constipation in animal models. [24][25][26] Recently, a few of clinical studies found that EA at ST-36 accelerates the recovery of gastrointestinal motility after colorectal surgery 20,[27][28][29] As shown by Simon SM Ng, patients who received EA had a shorter time to defecation than patients who received no EA after laparoscopic surgery for colorectal cancer.…”

Efficacy and safety of long-term transcutaneous electroacupuncture versus sham transcutaneous electroacupuncture for delayed gastric emptying after distal gastrectomy: study protocol for a randomized, patient-assessor blinded, controlled trial

“…A small number of clinical studies proved that TEA could significantly improve gastric emptying in dyspeptic patients [ 17 ]. Our previous randomized, controlled, single-center study demonstrated that TEA improved bowel movement and alleviated postoperative ileus after gastrectomy [ 18 ].…”