The effect of acupuncture on recovery after colorectal cancer resection: A systematic review meta-analysis of randomized controlled trials

Abstract

Background: To evaluate the efficacy and safety of acupuncture by systematically reviewing the literature on colorectal cancer resection.

Methods: Seven electronic databases were searched from inception to February 28, 2023. Randomized controlled trials on acupuncture in patients after CRC resection were included. Two reviewers independently selected relevant trials, extracted data, and assessed the risk of bias. A random-effects meta-analysis model was used to obtain summary effect estimates. The data were pooled and analyzed using RevMan 5.3. The heterogeneity of selected studies was evaluated by evaluating the I-squared (I2) statistics.

Results: Twenty-two studies with 1878 patients were included. Results of the meta-analysis showed there was a low level evidence that acupuncture may improve early postoperative symptoms, such as time to first flatus (n = 876, MD -0.77h, 95% CI -1.22 to -0.33 h, I2 = 89%), time to first bowel movement (n = 671, MD -1.41h, 95% CI -2.20 to -0.63 h, I2 = 95%), time to first defecation (n = 556, MD -1.03h, 95% CI -1.88 to -0.18 h, I2 = 95%), and nausea/vomiting (n = 1488, RR 0.72, 95% CI 0.59-0.89, I2 = 49%) compared with usual care and sham acupuncture. However, there were no statistically significant differences in postoperative pain (n = 1188, MD-0.21, 95% CI -0.59 to 0.17, I2 = 74%). And there was no sufficient evidence of improving long-term functional outcomes. There was substantial heterogeneity across trials. The adverse events associated with acupuncture stimulation were minor in include studies.

Conclusion subsections: There is currently low-level evidence supporting the use of acupuncture on postoperative symptoms for patients after colorectal cancer resection. More investigations should be established based on the STRICTA statement strictly.

Figure 1.

Study flow diagram.

Figure 2.

Risk of bias summary.

Figure 3.

Risk of bias graph.

Figure 4.

The effect of acupuncture on hours to first flatus.

Figure 5.

The effect of acupuncture on first bowel movement.

Figure 6.

The effect of acupuncture on first defecation.

Figure 7.

The effect of acupuncture on postoperative pain.

Figure 8.

Funnel plot.

Figure 9.

The effect of acupuncture on the occurrence of PONV. PONV = postoperative nausea and vomiting.

Figure 10.

The effect of acupuncture on the severity PONV. PONV = postoperative nausea and vomiting.