Perioperative Transcutaneous Electrical Acupoint Stimulation for Improving Postoperative Gastrointestinal Function in Patients Undergoing Laparoscopic Colorectal Tumour Resection: A Randomized Controlled Trial

Abstract Background Postoperative gastrointestinal dysfunction (POGD) is a common complication in postoperative patients. Transcutaneous electrical acupoint stimulation (TEAS) may facilitate the recovery of patients with POGD. However, no consensus has been reached regarding the selection of acupoint compatibility. To our knowledge, this is the first trial in which upper abdominal acupoints combined with lower limb acupoints have been used to prevent POGD. Methods In this two-arm, parallel, single-blinded randomized controlled trial, we enrolled 184 patients scheduled for laparoscopic colorectal cancer resection. After exclusions, 162 in the the modified intention-to-treat analysis (TEAS group, n = 81) and (Control group, n = 81), one control patient withdrew before anaesthesia, leaving 81 and 80 patients, respectively. The primary outcome was time to first flatus; Secondary outcomes: time to first bowel motion and defecation, QoR-15 questionnaire scores, and postoperative hospital stay. Results Compared with those in the control group, patients in the TEAS group had shorter durations to first flatus (55.51 ± 16.14 hours vs. 70.89 ± 10.89 hours; mean difference: -15.39; 95% confidence interval (CI): -19.67 to -11.10; P < 0.001), first-time bowel sound recovery (16.78 ± 3.63 hours vs. 24.76 ± 5.04 hours; mean difference: -7.98; 95% CI: -9.35 to -6.61; P < 0.001), first-time defecation (96.81 ± 18.41 hours vs. 109.33 ± 14.62 hours; mean difference: -12.52; 95% CI: -17.69 to -7.74; P < 0.001), and shorter postoperative hospital stays (7.94 ± 1.72 days vs. 10.85 ± 4.08 days; mean difference: -2.91; 95% CI: -3.88 to -1.94; P < 0.001). Compared with control patients, patients in the TEAS group had higher QoR-15 scores on postoperative day 3 (108.33 ± 11.34 vs. 103.90 ± 14.69; mean difference: 4.43; 95% CI: 0.35 to 8.52; P = 0.034). With no multiple comparison correction performed, exploratory QoR-15 analyses yielded marginally significant trends suggesting that perioperative TEAS may improve postoperative appetite, sleep quality, pain and postoperative nausea and vomiting (PONV). The other secondary outcomes did not differ between the groups. There were no severe adverse events. Conclusions Perioperative TEAS at CV12 and bilateral ST36, ST37, and ST39 shortened the time to first flatus and may facilitate early recovery of gastrointestinal function after laparoscopic colorectal tumour resection. Trial registration: Chinese Clinical Trial Registry (https://www.chictr.org.cn, ChiCTR2400090939), registered on October 16th, 2024.