Naturopathic Treatment and Complementary Medicine in Surgical Practice

Abstract

omplementary medicine (CM) and naturopathic treatments (NT) are relevant topics for clinically active physicians. Many patients either would like to have advice about CM/NT or are already using them on their own for mostly harmless and self-limiting diseases (1). Indeed, more than 50% of cancer patients report using CM/NT. This not only affects primary care physicians, but also oncologists, radiotherapists, anesthesiologists, palliative care physicians, and surgeons (1). Nonetheless, little-to-no efforts seem to have been made at integrating CM/NT into everyday surgical routines. Surgeons are confronted not only with the needs of cancer patients but also with those of non-cancer patients undergoing surgery, as up to 30% of patients in this group also report using CM/NT (2, 3). Furthermore, although up to 60% of patients who undergo surgery would like complementary medical advice, almost none of them discuss this with the treating surgeon (3). This is a critical point, as self-medication with herbal supplements can lead to interactions with other drugs and cause risks, such as interference with blood clotting. This article therefore aims to give an overview of possible supportive CM/NT approaches in surgery while at the same time addressing their risks. Methods After evaluation of typical postoperative problems by the authors, a systematic literature review was conducted via Medline, Web of Science, and the Cochrane Library. Randomized controlled trials (RCTs) and experimental human studies, as well as systematic reviews, were included. Detailed information on the methodology is presented in the eMethods section and in the eBox. This review was prospectively registered in PROSPERO (CRD42018095330). Results A total of 387 references were identified, of which 76 were suitable for evaluation after checking the inclusion and exclusion criteria (eFigure). Improvement of gastrointestinal function Three systematic reviews (two of high quality) were identified that reported the use of acupuncture and acupressure for impaired gastrointestinal function Summary Background: Many patients in Germany use naturopathic treatments and complementary medicine. Surveys have shown that many also use them as a concomitant treatment to surgery. Methods: Multiple databases were systematically searched for systematic reviews, controlled trials, and experimental studies concerning the use of naturopathic treatments and complementary medicine in the management of typical postoperative problems (PROSPERO CRD42018095330). Results: Of the 387 publications identified by the search, 76 fulfilled the inclusion criteria. In patients with abnormal gastrointestinal activity, acupuncture can improve motility, ease the passing of flatus, and lead to earlier defecation. Acupuncture and acupressure can reduce postoperative nausea and vomiting, as well as pain. Moreover, aromatherapy and music therapy seem to reduce pain, stress and anxiety and to improve sleep. Further studies are needed to determine whether phytotherapeutic treatments are effective for...

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Integrative Medicine and Plastic Surgery: A Synergy—Not an Antonym

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