Electroacupuncture for Postoperative Gastrointestinal Recovery After Laparoscopic Colorectal Cancer Resection: A Randomized Controlled Trial Electroacupuncture Fastens Recovery.
BACKGROUND Globally, the disease burden of colorectal cancer has been gradually increasing. Radical resection is the cornerstone treatment for colorectal cancer, but postoperative gastrointestinal dysfunction has been a potential complication. Current therapies are unsatisfactory. Acupuncture has the merits of inexpensive and easy-operative and has the potential to be a promising strategy. OBJECTIVE This study aimed to observe the effect and safety of electroacupuncture in facilitating the postoperative recovery of colorectal cancer patients. DESIGN Randomized controlled study. SETTING Prospective, single-center study. PATIENTS Patients over 18 years old who undergone radical resection of colorectal cancer. INTERVENTIONS Electroacupuncture or sham electroacupuncture at 2h after surgery and on the morning of the first 2 days after surgery, with 30 minutes each session. OUTCOMES The primary outcome was first flatus time. Secondary outcomes included first oral feeding time, bowel sound recovery time, length of postoperative hospitalization, adverse events, serum inflammatory cytokine indicators and heart rate variability indicators. RESULTS One hundred fifteen patients met the inclusion criteria and 101 patients completed the treatment and were enrolled into statistical analysis. There was no statistically significant difference (p > 0.05) in baselines. First flatus time, first oral feeding time, bowel sound recovery time were improved in electroacupuncture group (p < 0.05). Length of postoperative hospitalization was not significantly different. On postoperative day 1, interleukin-1β was lower in electroacupuncture group (p < 0.05); On postoperative day 3, interleukin -1 β, and interleukin -6 were lower in electroacupuncture group (p < 0.05). Percentage of difference between adjacent normal RR intervals exceeding 50ms and high frequency were higher in electroacupuncture group (p < 0.05). Kaplan-Meier curve analysis, multiple linear regression and correlation analysis secured the stability of the main results. LIMITATIONS This is a single-center trial with a small sample size and long-term follow-up was absent. No blank control group was set. CONCLUSIONS EA facilitated postoperative recovery without increasing the incidence of complications. This effect was hypothesized to be related to lower IL-1β/IL-6 levels and the rebalance of autonomic nervous system. See Video Abstract.Clinical trial registration: The trial has been registered at chictr.org.cn (ChiCTR2100050660 https://www.chictr.org.cn/hvshowproject.html?id=167502&v=1.9).