Does invasive acupuncture improve postoperative ileus after colorectal cancer surgery? A systematic review and meta-analysis

Frontiers in Medicine

Medicine

Shangkun Si¹  Jingxuan Liu¹  Xiaohu Zhao¹  Dongbin Zhang²  Aihua Hou³  Yuejun Mu³  Xin Liu³ 

[1] College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China;Department of Anesthesiology, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China;Department of Oncology, Yantai Hospital of Traditional Chinese Medicine, Yantai, China;

关键词: acupuncture therapy;    meta-anlaysis;    postoperative complications;    surgical oncology;    Traditional Chinese Medicine;   

DOI  :  10.3389/fmed.2023.1201769

 received in 2023-04-07, accepted in 2023-08-15,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundPostoperative ileus (POI) is one of the main complications after colorectal cancer (CRC) surgery, and there is still a lack of effective treatment. At present, the evidence for improvement of POI by invasive acupuncture (manual acupuncture and electroacupuncture, IA) is limited. This meta-analysis of randomized controlled trials (RCTs) aims to systematically review and evaluate the effect of IA in improving POI after CRC surgery.MethodsThis meta-analysis was reported according to PRISMA statement and AMSTAR guidelines. The retrieval time was from the inception to February 2023. The RCTs were screened by searching the databases (PubMed, Ovid, Embase, Cochrane Library, China National Knowledge Infrastructure, VIP Database, Sinomed Database, and WANFANG). Two independent investigators screened and extracted the data, assessed the risk of bias, and performed statistical analysis. The statistical analysis was carried out by RevMan5.3. The PROSPERO International Prospective Register of Systematic Reviews received this research for registration (CRD42023387700).ResultsThirteen studies with 795 patients were included. In the primary outcome indicators: the IA group had shorter time to the first flauts [stand mean difference (SMD), −0.57; 95% CI, −0.73 to −0.41, p < 0.00001], shorter time to the first defecation [mean difference (MD), −4.92 h, 95% CI −8.10 to −1.74 h, p = 0.002] than the blank/sham stimulation (B/S) group. In the secondary outcome indicators: the IA group had shorter time to the first bowel motion (MD, −6.62 h, 95% CI −8.73 to −4.50 h, p < 0.00001), shorter length of hospital (SMD, −0.40, 95% CI −0.60 to −0.21, p < 0.0001) than the B/S group. In terms of the subgroup analysis: IA associated with enhanced recovery after surgery (ERAS) group had shorter time to the first flauts (MD, −6.41 h, 95% CI −9.34 to −3.49 h, p < 0.0001), shorter time to the first defacation (MD, −6.02 h, 95% CI −9.28 to −2.77 h, p = 0.0003) than ERAS group.ConclusionInvasive acupuncture (IA) after CRC surgery, acupuncture or electricacupuncture with a fixed number of times and duration at therapeutic acupoints, can promote the recovery of POI. IA combined with ERAS is better than simple ERAS in improving POI.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=387700, identifier CRD42023387700.

【 授权许可】

Unknown   
Copyright © 2023 Zhao, Si, Liu, Liu, Zhang, Mu and Hou.