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©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Feb 27, 2018; 10(2): 13-20
Published online Feb 27, 2018. doi: 10.4240/wjgs.v10.i2.13
Transcutaneous electroacupuncture alleviates postoperative ileus after gastrectomy: A randomized clinical trial
Kai-Bo Chen, Yi-Qiao Lu, Jian-De Chen, Di-Ke Shi, Zhi-Hui Huang, Yi-Xiong Zheng, Xiao-Li Jin, Zhe-Fang Wang, Wei-Dong Zhang, Yi Huang, Zhi-Wei Wu, Guo-Ping Zhang, Hang Zhang, Ying-Hao Jiang, Li Chen
Kai-Bo Chen, Di-Ke Shi, Yi-Xiong Zheng, Xiao-Li Jin, Zhi-Wei Wu, Hang Zhang, Li Chen, Yi-Huang, Department of General Surgery, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310000, Zhejiang Province, China
Yi-Qiao Lu, Department of Obstetrics and Gynecology, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou 310006, Zhejiang Province, China
Jian-De Chen, Division of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, Baltimore, MD 21224, United States
Zhi-Hui Huang, Department of Gastroenterology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, Zhejiang Province, China
Zhe-Fang Wang, Department of General, Visceral and Cancer Surgery, University of Cologne, Cologne 50937, Germany
Wei-Dong Zhang, Department of Thyroid Surgery, Ningbo No. 2 Hospital, Ningbo 315000, Zhejiang Province, China
Guo-Ping Zhang, Department of Chinese Medicine Rehabilitation, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310000, Zhejiang Province, China
Ying-Hao Jiang, Department of General Surgery, First People’s Hospital of Wenling, Taizhou 317500, Zhejiang Province, China
Author contributions: Chen KB, Lu YQ, Chen JD, Chen L, Shi DK and Huang ZH designed and established the study process; Chen KB, Lu YQ, Chen L and Shi DK performed the study, collected and analyzed the data and wrote and revised the manuscript; Wang ZF, Huang Y, Wu ZW and Jiang YH contributed to patient recruitment and performing the study; Zheng YX assisted with protocol development and patient management; Zhang GP assisted with acupuncture techniques; Chen KB and Lu YQ contributed equally to this research.
Supported by Zhejiang Provincial Chinese Medicine Scientific Research Fund, No. 2017ZA085.
Institutional review board statement: Institutional review board of the Second Affiliated Hospital of Zhejiang University School of Medicine passed ethics for this research (No. 2013-051-C01).
Informed consent statement: Informed consents were obtained from all participates.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Li Chen, MD, Professor, Department of General Surgery, Second Affiliated Hospital of Zhejiang University School of Medicine, 88 Jie-fang Road, Hangzhou 310000, Zhejiang Province, China. li-chen@zju.edu.cn
Telephone: +86-571-87783777
Received: November 14, 2017
Peer-review started: November 15, 2017
First decision: December 8, 2017
Revised: December 9, 2017
Accepted: February 5, 2018
Article in press: February 6, 2018
Published online: February 27, 2018
AIM
To investigate the efficacy and safety of transcutaneous electroacupuncture (TEA) to alleviate postoperative ileus (POI) after gastrectomy.
METHODS
From April 2014 to February 2017, 63 gastric cancer patients were recruited from the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China. After gastrectomy, the patients were randomly allocated to the TEA (n = 33) or control (n = 30) group. The patients in the TEA group received 1 h TEA on Neiguan (ST36) and Zusanli (PC6) twice daily in the morning and afternoon until they passed flatus. The main outcomes were hours to the first flatus or bowel movement, time to nasogastric tube removal, time to liquid and semi-liquid diet, and hospital stay. The secondary outcomes included postoperative symptom assessment and complications.
RESULTS
Time to first flatus in the TEA group was significantly shorter than in the control group (73.19 ± 15.61 vs 82.82 ± 20.25 h, P = 0.038), especially for open gastrectomy (76.53 ± 14.29 vs 87.23 ± 20.75 h, P = 0.048). Bowel sounds on day 2 in the TEA group were significantly greater than in the control group (2.30 ± 2.61/min vs 1.05 ± 1.26/min, P = 0.017). Time to nasogastric tube removal in the TEA group was earlier than in the control group (4.22 ± 1.01 vs 4.97 ± 1.67 d, P = 0.049), as well as the time to liquid diet (5.0 ± 1.34 vs 5.83 ± 2.10 d, P = 0.039). Hospital stay in the TEA group was significantly shorter than in the control group (8.06 ± 1.75 vs 9.40 ± 3.09 d, P = 0.041). No significant differences in postoperative symptom assessment and complications were found between the groups. There was no severe adverse event related to TEA.
CONCLUSION
TEA accelerated bowel movements and alleviated POI after open gastrectomy and shortened hospital stay.
Core tip: Transcutaneous electroacupuncture (TEA) is a non-invasive and portable device. We applied TEA on postoperative gastric cancer patients to promote the bowel motility recovery. As far as we are concerned, it was the first attempt to investigate the efficacy and safety of TEA to alleviate postoperative ileus after gastrectomy.
