Electroacupuncture Reduces Duration of Postoperative Ileus After Laparoscopic Surgery for Colorectal Cancer

Division of Colorectal Surgery, Department of Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong SAR.. Electronic address: .
Gastroenterology (Impact Factor: 13.93). 11/2012; 144(2). DOI: 10.1053/j.gastro.2012.10.050
Source: PubMed

ABSTRACT BACKGROUND & AIMS:: We investigated the efficacy of electroacupuncture in reducing the duration of postoperative ileus and hospital stay after laparoscopic surgery for colorectal cancer. METHODS:: We performed a prospective study of 165 patients undergoing elective laparoscopic surgery for colonic and upper rectal cancer, enrolled from October 2008 to October 2010. Patients were randomly assigned to groups that received electroacupuncture (n = 55) or sham acupuncture (n = 55), once daily from post-operative days 1-4, or no acupuncture (n = 55). The acupoints Zusanli, Sanyinjiao, Hegu, and Zhigou were used. The primary outcome was time to defecation. Secondary outcomes included postoperative analgesic requirement, time to ambulation, and length of hospital stay. RESULTS:: Patients that received electroacupuncture had shorter time to defecation than patients that received no acupuncture (85.9 ±3 6.1 vs 122.1 ± 53.5 hours, P < .001) and length of hospital stay (6.5 ± 2.2 vs 8.5 ± 4.8 days, P = .007). Patients that received electroacupuncture also had shorter time to defecation than patients that received sham acupuncture (85.9 ± 36.1 vs 107.5 ± 46.2 hours, P = .007). Electroacupuncture was more effective than no or sham acupuncture in reducing postoperative analgesic requirement and time to ambulation. In multiple linear regression analysis, an absence of complications and electroacupuncture were associated with shorter duration of postoperative ileus and hospital stay after the surgery. CONCLUSIONS:: In a clinical trial, electroacupuncture reduced duration of postoperative ileus, time to ambulation, and postoperative analgesic requirement, compared with no or sham acupuncture, after laparoscopic surgery for colorectal cancer. number, NCT00464425.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Along with a growing awareness of quality in healthcare, has come a focus on postanesthetic morbidities, which still remain challenging in our daily practice of anesthesia. Acupuncture and related techniques (acustimulation) are often suggested to be adequate treatments with low cost and minimal adverse effects. This review focuses on the current evidence and applicability of these techniques for use in ambulatory anesthesia. Trials exploring the effects of acustimulation may produce ambiguous results and sometimes be difficult to evaluate. Controversies still remain as to the clinical relevance. Recent trials suggest that acustimulation may prevent postoperative pain, nausea and vomiting. There are also promising results for the use of the techniques in reducing preoperative anxiety, postoperative shivering and emergence delirium. Pharmacological drug treatment may be only partially effective and produce an adverse event. Research suggests that acustimulation may alleviate postoperative morbidities, although the body of evidence of the effect is equivocal. The treatments are easy to perform, and adverse events and costs are minimal. It may be profitable to implement this beneficial treatment to ambulatory patients.
    Current opinion in anaesthesiology 10/2013; 26(6). DOI:10.1097/ACO.0000000000000017 · 2.53 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The acupuncture has been practiced in China for more than 3000 years and was spread to Europe and American from the sixteenth to the nineteenth century. The history of acupuncture research was initiated in the eighteenth century and developed rapidly since then. In the past, physicians tried hard to apply acupuncture into clinical practice, while scientists were focused on the possible characteristics of acupoints and meridians. In the modern time, scientists have strived hard to evaluate the real effectiveness of acupuncture and the underlying physiological and biological mechanisms of acupuncture. Reviewing research history from past to present, we are delighted to witness this wonderful development. Accumulated evidences that acupuncture is beneficial in various conditions significantly enhanced our understanding the mechanisms of acupuncture treatment. However, there is still no conclusive evidence in acupuncture clinical studies. The clinical research still needs great improving, while the basic research results need to be appropriately transformed into clinical outcomes. Based on current achievements, we believe that although the challenges and difficulties exist, a more collaborative, innovative, and integrated approach will help us to achieve further progress in future acupuncture research.
    International Review of Neurobiology 01/2013; 111:1-23. DOI:10.1016/B978-0-12-411545-3.00001-8 · 2.46 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background. The pathogenesis of postoperative ileus (POI) is complex. The present study was designed to investigate the effects of peritoneal air exposure on the POI intestinal inflammation and the underlying mechanism. Methods. Sprague-Dawley rats were randomized into five groups (6/group): the control group, the sham group, and three exposure groups with peritoneal air exposure for 1, 2, or 3 h. At 24 h after surgery, we analyzed the gastrointestinal transit, the serum levels of tumor necrosis factor (TNF)-α, interleukin (IL)-1β, IL-6, and IL-10, the myeloperoxidase activity, and the levels of TNF-α, IL-1β, IL-6, and IL-10 in the ileum and colon. The oxidant and antioxidant levels in the ileum and colon were analyzed by measuring malondialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), and total antioxidant capacity (T-AOC). Results. Peritoneal air exposure caused an air-exposure-time-dependent decrease in the gastrointestinal transit. The length of peritoneal air exposure is correlated with the severity of both systemic and intestinal inflammations and the increases in the levels of MDA, SOD, GSH-Px, and T-AOC. Conclusions. The length of peritoneal air exposure is proportional to the degree of intestinal paralysis and the severity of intestinal inflammation, which is linked to the oxidative stress response.
    Mediators of Inflammation 07/2014; 2014:924296. DOI:10.1155/2014/924296 · 2.42 Impact Factor