Acupuncture for Quality of Life of Patients with Defecation Dysfunction after Sphincter Preserving Surgery for Rectal Cancer: A Systematic Review

Abstract

Purpose. To evaluate the effectiveness and safety of acupuncture for quality of life of patients with defecation dysfunction (DD) after sphincter preserving surgery for rectal cancer. Methods. We searched nine online databases from inception to July 1, 2021, and did not restrict the type of language. Then, studies were independently selected by two research team members with screening criteria and risk bias assessment, and the data were extracted. The primary outcome was Quality of Life Questionnaire-Core 29 (QLQ-CR29). The data were then synthesized using the RevMan V.5.2 by random-effects model. Also, we used the standardized mean differences with 95% credible interval (CI) to describe the outcome of the analysis. Results. A total of 6 randomized controlled trials (RCTs) (with 439 patients) were included in the systematic review, and data from 2 RCTs (with 200 patients) were used in the meta-analysis. Five studies (83%) were judged to have a medium risk of bias, and one was at high risk of bias. For synthesis, data from two medium-risk studies found that acupuncture or electropuncture may improve the QLQ-CR29 with urination (mean difference, −0.39 points; 95%CI, −0.46 to −0.32; I2 = 34%), abdominal pain (mean difference, −0.71 points; 95%CI, −0.89 to −0.54; I2 = 9%), stool (mean difference, −0.49 points; 95%CI, −0.77 to −0.20; I2 = 57%), defecation (mean difference, −0.59 points; 95% CI, −0.85 to −0.33; I2 = 51%), sexual function (mean difference, 0.93 points; 95% CI, 0.48 to 1.38; I2 = 90%), and self-feelings (mean difference, 1.04 points; 95% CI, 0.36 to 1.73; I2 = 94%). Conclusion. Findings in this study indicate that acupuncture or electropuncture may be effective and safe for DD, but the quality of included studies was very low. So, more large-scale, multicenter, long-term, and high-quality original research is still expected in the future.

Evaluating the clinical application and effect of acupuncture therapy in anal function rehabilitation after low-tension rectal cancer surgery

“…After surgery, patients’ qi is less positive, and effectively eliminating the turbidity and toxicity is difficult. Continuing turbidity and toxicity in the body affects the balance of the five zang organs, leading to the appearance of many anal symptoms[ 8 , 9 ]. Acupuncture therapy is an effective method to improve the anal function of patients, anus week as point.…”

A comparative study of acupuncture combined with rehabilitation gymnastics on postoperative anal function of lower rectal cancer

“…Based on the theory of turbidity and toxins, acupuncture therapy follows the therapeutic principle of supplementing qi, strengthening the spleen, clearing turbidity, and eliminating toxins, and adopting acupuncture and moxibustion techniques of deficiency and excess. Through stimulation of selected acupoints, acupuncture therapy can dredge meridians, balance the five Zang organs, and promote recovery of anal function in patients with lower rectal cancer after surgery[ 15 ]. Rehabilitation gymnastics can promote local blood circulation in the anus and improve the anal sphincter function.…”

The Effects of Complementary Therapies on Patient-Reported Outcomes: An Overview of Recent Systematic Reviews in Oncology

“…Furthermore, acupuncture may be effective for improving the quality of life in patients with colorectal cancer by improving abdominal pain, stool score, defecation dysfunction, sexual dysfunction and self-feelings [36]. * Asterisk = significant effect; no asterisk = no significant effect.…”