Perioperative Electroacupuncture Can Accelerate the Recovery of Gastrointestinal Function in Cancer Patients Undergoing Pancreatectomy or Gastrectomy: A Randomized Controlled Trial

Abstract

The effect of perioperative acupuncture on accelerating gastrointestinal function recovery has been reported in colorectal surgery and distal gastrectomy (Billroth-II). However, the evidence in pancreatectomy and other gastrectomy is still limited. A prospective, randomized controlled trial was conducted between May 2018 and August 2019. Consecutive patients undergoing pancreatectomy or gastrectomy in our hospital were randomly assigned to the electroacupuncture (EA) group and the control group. The patients in the EA group received transcutaneous EA on Bai-hui (GV20), Nei-guan (PC6), Tian-shu (ST25), and Zu-san-li (ST36) once a day in the afternoon, and the control group received sham EA. Primary outcomes were the time to first flatus and time to first defecation. In total, 461 patients were randomly assigned to the groups, and 385 were analyzed finally (EA group, n = 201; control group, n = 184). Time to first flatus (3.0 ± 0.7 vs 4.2 ± 1.0, P < 0.001 ) and first defecation (4.2 ± 0.9 vs 5.4 ± 1.2, P < 0.001 ) in the EA group were significantly shorter than those in the control group. Of patients undergoing pancreatectomy, those undergoing pancreaticoduodenectomy and intraoperative radiation therapy (IORT) surgery benefitted from EA in time to first flatus ( P < 0.001 ) and first defecation ( P < 0.001 ), while those undergoing distal pancreatectomy did not ( P flatus = 0.157 , P defecation = 0.007 ) completely. Of patients undergoing gastrectomy, those undergoing total gastrectomy and distal gastrectomy (Billroth-II) benefitted from EA ( P < 0.001 ), as did those undergoing proximal gastrectomy ( P = 0.015 ). Patients undergoing distal gastrectomy (Billroth-I) benefitted from EA in time to first defecation ( P = 0.012 ) but not flatus ( P = 0.051 ). The time of parenteral nutrition, hospital stay, and time to first independent walk in the EA group were shorter than those in the control group. No severe EA complications were reported. EA was safe and effective in accelerating postoperative gastrointestinal function recovery. Patients undergoing pancreaticoduodenectomy, IORT surgery, total gastrectomy, proximal gastrectomy, or distal gastrectomy (Billroth-II) could benefit from EA. This trial is registered with NCT03291574.

A Prospective Study of Using Chaihu Shugan Powder Combined with Zu San Li Acupoint Stimulation to Improve the Prognosis of Liver Stagnation and Qi Stagnation Syndrome in Acute Pancreatitis

“…Firstly, the pain of patients was reduced, suggesting that TCM compound therapy for acute pancreatitis may play a therapeutic role from different angles and through different targets. A large number of clinical and basic studies have not only confirmed the therapeutic effect of Chinese herbal formulas on acute pancreatitis but also preliminarily revealed the mechanism of these therapeutic effects [ 28 , 29 ]. Sometimes, fatal acute pancreatitis is caused by a systemic uncontrolled inflammatory response, and the resulting gastrointestinal function damage is one of the main causes of death.…”

Influence of Diagnostic Informing on Negative Emotions, Illness Perception, Self-Perceived Burden, and Posttraumatic Stress Disorder in Patients with Gastrointestinal Tumors

“…ere is no obvious manifestation in the initial stage of the disease, but with the progress of the disease, symptoms such as abdominal pain, hematemesis, melena, and intestinal obstruction may appear and even lead to multiple organ failure, which is life-threatening and has a great impact on the quality of life of patients [2]. At present, surgery, chemotherapy, radiotherapy, and traditional Chinese medicine therapy are common clinical tumor treatments, which have a certain effect on patients with gastrointestinal tumors and can improve the prognosis of patients [3].…”

Electroacupuncture vs Sham Electroacupuncture in the Treatment of Postoperative Ileus After Laparoscopic Surgery for Colorectal Cancer

“…Ng and colleagues found that EA reduced the time to first defecation (85.9 hours) as compared with SA (107.5 hours) after laparoscopic surgery in traditional nursing care. In a recently published acupuncture trial, Qiu et al reported that the time to first defecation was 4.2 days and 5.4 days in the EA and SA group, respectively, after pancreatectomy or gastrectomy without the ERAS protocol. The median (IQR) time to first defecation in this trial was 76.4 (67.6-96.8) hours in the EA group and 90.0 (73.6-100.3) hours in the SA group.…”