Comparing apples to oranges? The challenges of conducting research on postoperative ileus

Abstract

In their recently published multicenter randomized controlled trial, 1 Gao W. Li W. Yan Y. et al. Transcutaneous electrical acupoint stimulation applied in lower limbs decreases the incidence of paralytic ileus after colorectal surgery: a multicenter randomized controlled trial. Surgery. 2021; 170: 1618-1626 Abstract Full Text Full Text PDF Scopus (1) Google Scholar Gao et al (2021) from China evaluated the effect of transcutaneous acupoint electrical stimulation (TEAS) on the occurrence of postoperative ileus (POI) after elective colorectal cancer surgery. The trial was the largest of its kind to date, randomizing 610 patients to either TEAS or a sham intervention (identical electrode placement on acupoints but without electrical stimulation). Compared with patients in the sham group, patients who underwent TEAS had a significantly lower incidence of POI (32.3% vs 41.0%, P = .026; odds ratio: 0.68, 95% confidence interval [CI] 0.48–0.96) and earlier time to first flatus by 12.8 hours (95% CI 7.5–18.2). Patients who underwent TEAS also had an increased serum concentration of acetylcholine and decreased serum concentrations of interleukin-6 and inducible nitric oxide synthase, suggesting that TEAS may reduce POI through its parasympathetic and anti-inflammatory effects. Transcutaneous electrical acupoint stimulation applied in lower limbs decreases the incidence of paralytic ileus after colorectal surgery: A multicenter randomized controlled trialSurgeryVol. 170Issue 6PreviewPostoperative paralytic ileus prolongs hospitalization duration, increases medical expenses, and is even associated with postoperative mortality; however, effective prevention of postoperative paralytic ileus is not yet available. This trial aimed to assess the preventative effectiveness of transcutaneous electrical acupoint stimulation applied in the lower limbs on postoperative paralytic ileus incidence after colorectal surgery. Full-Text PDF