Effect of Acupuncture on Postoperative Ileus after Distal Gastrectomy for Gastric Cancer

PURPOSE: Acupuncture has recently been accepted as a treatment option for managing postoperative ileus (POI) and various functional gastrointestinal disorders. Therefore, we conducted a prospective randomized study to evaluate the effect of acupuncture on POI and other surgical outcomes in patients who underwent gastric surgery. MATERIALS AND METHODS: Thirty-six patients who underwent distal gastrectomy for gastric cancer from March to December 2015 were randomly assigned to acupuncture or non-acupuncture (NA) groups at 1:1 ratio. The acupuncture treatment was administered treatment once daily for 5 consecutive days starting at postoperative day 1. The primary outcome measure was the number of remnant sitz markers in the small intestine on abdominal radiograph. The secondary outcome measure was the surgical outcome, including the times to first flatus, first defecation, start of water intake, and start of soft diet, as well as length of hospital stay and laboratory findings. RESULTS: The acupuncture group had significantly fewer remnant sitz markers in the small intestine on postoperative days 3 and 5 compared to those in the NA group. A significant difference was observed in the numbers of remnant sitz markers in the small intestine with respect to group differences by time (P<0.0001). The acupuncture group showed relatively better surgical outcomes than those in the NA group, but the differences were not statistically significant. CONCLUSIONS: In this clinical trial, acupuncture promoted the passage of sitz markers, which may reflect the possibility of reducing POI after distal gastrectomy.

Comparison of Recovery of Bowel Motility after Laparoscopic-assisted and Open Surgery for Right Colon Cancer: A Study of Gastric Emptying by Using Sitz-marker(TM) and Changes of Intraperitoneal Temperature

PURPOSE: Early recovery of gastrointestinal motility is one of the main advantages of laparoscopic intestinal surgery. However, the reasons for this advantage are still not well known. To compare recovery of bowel motility after laparoscopic-assisted and open surgery for right colon cancer, we analyzed early clinical results, including both the gastric emptying time by using a Sitz-marker(TM) and the intraperitoneal temperature. METHODS: From January 1996 to December 1999, 80 curative right hemicolectomies, which were divided into a laparoscopic-assisted surgery group (LS) with 36 patients and an open surgery group (OS) with 44 patients, were prospectively, but not randomly, studied for recovery of bowel motility. Clinical results, such as the pain score, the time to gas passage, the time to resumption of meals the hospital stay and the gastric emptying time obtained by using a Sitz-markers(TM), were evaluated. At the beginning and the end of the operation, the intraperitoneal temperature was checked at three different points. RESULTS: In the LS and OS groups, the first flatus passed at the 3.0 and the 3.67 postoperative day (POD) and oral intake resumed at the 3.9 and the 5.2 POD, respectively (P0.05), 1.7 and 4.2 at the 3rd POD (P<0.05) and 0 and 1.1 at the 4th POD (P<0.05), respectively. No difference in intraperitoneal temperature was noted. CONCLUSIONS: We found earlier recovery of bowel function after laparoscopic surgery than after open surgery, but could not identify any relationship between bowel function and the possible parameter of intraperitoneal temperature.