Postoperative ileus is a common problem in patients who have major abdominal surgery. The duration is usually short, but prolonged postoperative ileus (PPOI) may lead to increased hospital stay and costs. Acupuncture is often used to treat gastrointestinal disorders in China, but it is still not known whether it is effective for preventing or treating PPOI. Information from a study group may help surgeons choose appropriate therapy for PPOI after abdominal surgery.
A research article to be published on January 7 , 2010 in the World Journal of Gastroenterology addresses this question. In this prospective randomized clinical trial, the authors examined if acupuncture could prevent prolonged postoperative ileus (PPOI) after intraperitoneal surgery among patients with colon cancer in Shanghai, China. Acupuncture did not prevent PPOI in this population. Subset analyses in patients who developed PPOI also suggested acupuncture was not useful in this setting to treat PPOI once it developed.
The study was part of a unique collaboration between researchers in the United States at The University of Texas M. D. Anderson Cancer Center in Houston, Texas and China at the Fudan University Cancer Hospital in Shanghai. Only one previous randomized trial, conducted in the United States, has examined the use of acupuncture to prevent PPOI in cancer patients. According to Meng and colleagues, standard postoperative care is very different in China than in the United States, and some of these treatment differences could play an important role in postoperative gastrointestinal motility and development of complications such as prolonged ileus. The authors state that future studies examining the use of acupuncture to prevent or treat PPOI should include assessment of activity, diet, and postoperative medication for pain control.
This study was funded by a grant from the National Cancer Institute. The Principal Investigator of the international collaboration, Dr. Lorenzo Cohen, stated the focus of the International Center of Traditional Chinese Medicine (TCM) for Cancer is to study TCM within its traditional context. Although the study was a negative trial, it is consistent with a similar trial conducted in the United States. We learned from this study that the specific use of certain acupuncture points in combination with standard postoperative care in China had no effect on PPOI, but it also demonstrated that we can conduct rigorous multinational research to examine TCM for cancer. Conducting rigorous research on TCM is an important step towards understanding the potential efficacy and mechanisms of many ancient therapies such as acupuncture.
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More information: Meng ZQ, Garcia MK, Chiang JS, Peng HT, Shi YQ, Fu J, Liu LM, Liao ZX, Zhang Y, Bei WY, Thornton B, Palmer JL, McQuade J, Cohen L. Electro-acupuncture to prevent prolonged postoperative ileus: A randomized clinical trial. World J Gastroenterol 2010; 16(1): 104-111 www.wjgnet.com/1007-9327/16/104.asp