Acupuncture helps ease postoperative ileus after GI surgery

Postoperative ileus (POI) may be reduced with acupuncture after gastrointestinal (GI) surgery, reports a recent meta-analysis. However, evidence supporting such an effect remains of poor quality, pointing to the need for further validation.

Researchers retrieved 18 randomized controlled trials from online databases of PubMed, Embase, the Cochrane Library, VIP, Wanfang, China National Knowledge Infrastructure, and Chinese Biomedical Literature Database. The cumulative sample included 1,413 patients who had undergone GI surgery.

Pooled analysis showed that acupuncture significantly reduced the time to first flatus as opposed to usual care (standardized mean difference [SMD], –1.14, 95 percent confidence interval [CI], –1.54 to –0.73; p<0.00001). A similar effect was reported for time to first defecation (SMD, –1.31, 95 percent CI, –1.88 to –0.74; p<0.00001). Such an effect was even better when acupuncture was applied to distal acupoints once daily after surgery.

Time to bowel sounds recovery (SMD, –1.57, 95 percent CI, –2.14 to –1.01; p<0.00001) and length of hospital stay (mean difference, –1.68, 95 percent CI, –2.55 to –0.80; p=0.0002) were likewise significantly better in the acupuncture arm when compared against usual care.

Findings were robust to sensitivity analyses, though the overall quality of evidence was poor, suggesting low certainty regarding the benefits of acupuncture on gastric symptoms.

“Taking into consideration of the very low to moderate quality of the overall body of evidence, the findings from this systematic review should be interpreted with caution. High-quality, large-sample, multicentre original studies are needed in the future,” the researchers said.