Abstract
Delays in recovery of intestinal function following abdominal surgery are associated with longer hospital stays, increased postoperative complications, and higher costs to the health care system. Studies of acupuncture for postoperative ileus and other postoperative issues have reported improvements. This systematic review and meta-analysis aimed to assess whether acupuncture assisted recovery following surgery for colorectal cancer (CRC). Randomized controlled trials (RCTs) were identified from major English and Chinese language biomedical databases. Participants (aged 18 years plus) had received surgical resection for CRC. 22 studies (1,628 participants) were included. Five were sham-controlled. Outcomes included gastrointestinal function recovery (21 studies), recovery of urinary function (1 study), postoperative abdominal distension (3 studies), and quality of life (1 study). Meta-analyses found significant reductions in time to first bowel sounds, first flatus, and first defecation in both the sham-controlled and nonblinded studies. These results suggested that the addition of acupuncture following CRC surgery improved recovery of gastrointestinal function based on four blinded good quality RCTs (281 participants) and 17 nonblinded lower quality RCTs (1,265 participants). The best available evidence was for interventions that included electroacupuncture at the point ST36 Zusanli and there is supporting evidence for other types of acupuncture therapies that involve stimulation of this point. This review is registered with the following: systematic review registration in PROSPERO: CRD42017079590.
Highlights
Delay in resumption of intestinal function following the surgery occurs in most patients after abdominal surgery including surgery for colorectal cancer (CRC) [1]
Known as postoperative ileus (POI), this condition typically resolves by day five following open abdominal surgery and by day three following laparoscopic surgery but it may be prolonged or recur and may be accompanied by abdominal distension, pain, and/or nausea and vomiting [2]
Studies of acupoint-injection, suture embedding, transcutaneous electrical nerve stimulation (TENS), acupuncture combined with oral herbal medicine, or other nonacupuncture-related therapy were excluded
Summary
Delay in resumption of intestinal function following the surgery occurs in most patients after abdominal surgery including surgery for CRC [1]. A review of acupuncture for symptom management in cancer found evidence of benefits [9] and an update found support for improvement in POI [10]. A meta-analysis of acupuncture for POI found that acupuncture might be effective in improving POI [11] and a systematic review of acupuncture for recovery after CRC surgery concluded that there was lowto-moderate quality evidence for the efficacy and safety of acupuncture for postoperative outcomes including POI [12]. Since these reviews were published, additional studies have become available
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