Electroacupuncture may reduce length of ileus after Colorectal Cancer surgery: JAMA

A new study conducted by Yu Wang and team shows that in contrast to sham electroacupuncture (SA), electroacupuncture (EA) reduced the length of postoperative ileus (POI) in patients receiving laparoscopic surgery for colorectal cancer. The findings of the study where published in the Journal of American medical Medical Association.

Postoperative ileus significantly hinders recovery following colorectal resection and adds to the strain on the healthcare system, despite the implementation of the optimal Enhanced Recovery After Surgery (ERAS) protocol. As a result, researchers undertook the study to evaluate the effectiveness of electroacupuncture in shortening the duration of POI when used in conjunction with the ERAS protocol.

From October 12, 2020, through October 17, 2021, a multicenter, randomized, sham-controlled experiment was undertaken in China. The dynamic block random approach was used for a 1:1 allocation, and intention-to-treat analyses were performed. A central system randomly assigned patients (18 years of age or older) to treatment groups for the first time they underwent laparoscopic resection of colorectal cancer. After surgery, patients were randomized to receive 4 sessions of electroacupuncture or sham electroacupuncture. Every patient received care according to the ERAS protocol.

The first defecation time was the main result. The incidence of postoperative complications and adverse events, the length of postoperative hospital stays, the readmission rate within 30 days, and other patient-reported outcome measures were considered secondary outcomes.

The key findings of the study were:

1. 249 patients in total were divided into therapy groups at random.

2. 248 participants were included in the analysis after 1 patient was excluded due to a diagnosis of intestinal tuberculosis.

3. In the EA group, the median (IQR) time to the first feces was 76.4 hours, but in the SA group, it was 90.0 hours.

4. The time to first flatus and the tolerability of semiliquid diet and solid meals were both considerably lower in the EA group compared to the SA group.

5. In the EA group, prolonged POI occurred in 13 of 125 patients (10%) while in the SA group, it happened in 25 of 123 patients (20%).

6. Other incidental results did not differ across groups. There were no serious negative incidents.

In conclusion, in order to encourage gastrointestinal function recovery and prevent extended POI after surgery, EA may be thought of as an adjuvant to the ERAS regimen.

Reference: 

Wang, Y., Yang, J.-W., Yan, S.-Y., Lu, Y., Han, J.-G., Pei, W., Zhao, J.-J., Li, Z.-K., Zhou, H., Yang, N.-N., Wang, L.-Q., Yang, Y.-C., & Liu, C.-Z. (2022). Electroacupuncture vs Sham Electroacupuncture in the Treatment of Postoperative Ileus After Laparoscopic Surgery for Colorectal Cancer. In JAMA Surgery. American Medical Association (AMA). https://doi.org/10.1001/jamasurg.2022.5674