La acupuntura y la electroacupuntura se han demostrado muy efectivas en el tratamiento de distintas patologías digestivas. Pero su utilidad puede también extenderse a los síntomas postoperatorios de la cirugía digestiva. El íleo postoperatorio, además del discomfort del paciente aumenta la estancia hospitalaria. Los fármacos no suelen ser muy útiles para el tratamiento de la disfunción intestinal postquirúrgica, y en algunos casos los efectos indeseables de los medicamentos son más relevantes que la propia recuperación de la función intestinal.

Presentamos dos estudios, uno del 2010 y otro del 2012. El primero tras cirugía intraperitoneal del cáncer de colon. Los resultados obtenidos en este estudio no han sido muy diferentes de los cuidados usuales. Puede que la anestesia tenga en estos casos mucha importancia. El segundo comprende cirugía laparoscópica del cáncer de colon. En este último se observó una franca recuperación del íleo postoperatorio, disminución del consumo de analgésicos, del tiempo hasta la deambulación y de la estancia hospitalaria. Es un procedimiento sencillo, sin efectos colaterales, y que además de proporcionar una mejoría objetiva en el paciente, ayuda a reducir los costos hospitalarios, que en los tiempos que corren pasa a tener mucha relevancia.

A continuación los abstracts de los dos trabajos:

 

World J Gastroenterol. 2010 Jan 7;16(1):104-11.

Electro-acupuncture to prevent prolonged postoperative ileus: a randomized clinical trial.

Meng ZQGarcia MKChiang JSPeng HTShi YQFu JLiu LMLiao ZXZhang YBei WYThornton BPalmer JLMcQuade JCohen L.

Source

Department of Integrative Oncology, Fudan University Cancer Hospital, Shanghai 200032, China.

Abstract

AIM:

To examine whether acupuncture can prevent prolonged postoperative ileus (PPOI) after intraperitoneal surgery for colon cancer.

METHODS:

Ninety patients were recruited from the Fudan University Cancer Hospital, Shanghai, China. After surgery, patients were randomized to receive acupuncture (once daily, starting on postoperative day 1, for up to six consecutive days) or usual care. PPOI was defined as an inability to pass flatus or have a bowel movement by 96 h after surgery. The main outcomes were time to first flatus, time to first bowel movement, and electrogastroenterography. Secondary outcomes were quality of life (QOL) measures, including pain, nausea, insomnia, abdominal distension/fullness, and sense of well-being.

RESULTS:

No significant differences in PPOI on day 4 (P = 0.71) or QOL measures were found between the groups. There were also no group differences when the data were analyzed by examining those whose PPOI had resolved by day 5 (P = 0.69) or day 6 (P = 0.88). No adverse events related to acupuncture were reported.

CONCLUSION:

Acupuncture did not prevent PPOI and was not useful for treating PPOI once it had developed in this population.

 

Gastroenterology. 2012 Nov 6. pii: S0016-5085(12)01609-5. doi: 10.1053/j.gastro.2012.10.050. [Epub ahead of print]

Electroacupuncture Reduces Duration of Postoperative Ileus After Laparoscopic Surgery for Colorectal Cancer.

Ng SSLeung WWMak TWHon SSLi JCWong CYTsoi KKLee JF.

Source

Division of Colorectal Surgery, Department of Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, SAR. Electronic address: simonng@surgery.cuhk.edu.hk.

Abstract

BACKGROUND & AIMS:

We investigated the efficacy of electroacupuncture in reducing the duration of postoperative ileus and hospital stay after laparoscopic surgery for colorectal cancer.

METHODS:

We performed a prospective study of 165 patients undergoing elective laparoscopic surgery for colonic and upper rectal cancer, enrolled from October 2008 to October 2010. Patients were assigned randomly to groups that received electroacupuncture (n = 55) or sham acupuncture (n = 55), once daily from postoperative days 1-4, or no acupuncture (n = 55). The acupoints Zusanli, Sanyinjiao, Hegu, and Zhigou were used. The primary outcome was time to defecation. Secondary outcomes included postoperative analgesic requirement, time to ambulation, and length of hospital stay.

RESULTS:

Patients who received electroacupuncture had a shorter time to defecation than patients who received no acupuncture (85.9 ± 3 6.1 vs 122.1 ± 53.5 h; P < .001) and length of hospital stay (6.5 ± 2.2 vs 8.5 ± 4.8 days; P = .007). Patients who received electroacupuncture also had a shorter time to defecation than patients who received sham acupuncture (85.9 ± 36.1 vs 107.5 ± 46.2 h; P = .007). Electroacupuncture was more effective than no or sham acupuncture in reducing postoperative analgesic requirement and time to ambulation. In multiple linear regression analysis, an absence of complications and electroacupuncture were associated with a shorter duration of postoperative ileus and hospital stay after the surgery.

CONCLUSIONS:

In a clinical trial, electroacupuncture reduced the duration of postoperative ileus, time to ambulation, and postoperative analgesic requirement, compared with no or sham acupuncture, after laparoscopic surgery for colorectal cancer. ClinicalTrials.gov number, NCT00464425.

Copyright © 2013 AGA Institute. Published by Elsevier Inc. All rights reserved.

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