Efficacy of electroacupuncture in improving postoperative ileus in patients receiving colorectal surgery: a systematic review and meta-analysis

Background: This meta-analysis aimed to evaluate the efficacy and safety of electroacupuncture (EA) in improving postoperative ileus after colorectal surgery. Methods: Electronic databases (e.g. Medline) were screened to identify randomized controlled trials that focused on the association between EA and postoperative ileus. Time to first flatus served as the primary outcome, while the secondary outcomes included time required for the recovery of other gastrointestinal functions (e.g. bowel sound recovery), time to tolerability of liquid/solid food, postoperative pain scores, risk of overall complications, and hospital length of stay. Results: Our meta-analysis focusing on 16 studies with a total of 1562 patients demonstrated positive associations of EA with shorter times to the first flatus [mean difference (MD): -10.1 h, P<0.00001, n=1562], first defecation (MD: -11.77 h, P<0.00001, n=1231), bowel sound recovery (MD: -10.76 h, P<0.00001, n=670), tolerability of liquid (MD: -16.44 h, P=0.0002, n=243), and solid food (MD: -17.21 h, P=0.005, n=582) than those who received standard care. The use of EA was also correlated with a lower risk of overall complications (risk ratio:0.71, P=0.04, n=1011), shorter hospital length of stay (MD: -1.22 days, P=0.0001, n=988), and a lower pain score on postoperative days two (standardized MD: -0.87, P=0.009, n=665) and three (standardized MD: -0.45, P<0.00001, n=795), without a difference in time to first ambulation. Conclusion: Our findings showed an association between EA and enhanced gastrointestinal functional recovery and reduced pain severity following colorectal surgery, highlighting the potential benefits of incorporating EA into perioperative care to enhance recovery outcomes in this setting.