Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Dec 27, 2023; 15(12): 2765-2773
Published online Dec 27, 2023. doi: 10.4240/wjgs.v15.i12.2765
Application of electroacupuncture in the prevention of low anterior resection syndrome after rectal cancer surgery
Lu-Lu Xu, Neng-Jun Xiang, Tian-Cheng Cheng, Yi-Xian Li, Peng Chen, Zhi-Wei Jiang, Xin-Xin Liu
Lu-Lu Xu, Neng-Jun Xiang, Tian-Cheng Cheng, Yi-Xian Li, Peng Chen, The First Clinical Medical College, Nanjing University of Traditional Chinese Medicine, Nanjing 210023, Jiangsu Province, China
Zhi-Wei Jiang, Xin-Xin Liu, Department of General Surger, Jiangsu Provincial Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Traditional Chinese Medicine, Nanjing 210029, Jiangsu Province, China
Co-first authors: Lu-Lu Xu and Neng-Jun Xiang.
Author contributions: Xu LL and Xiang NJ contributed equally to this work and are co-first authors, including design of the study, acquiring and analyzing data from experiments, and writing of the actual manuscript; Xu LL, Xiang NJ and Li YX designed the experiment and conducted clinical data collection; Liu XX, Cheng TC and Chen P performed postoperative follow-up and recorded data; Xu LL, Xiang NJ, Jiang ZW and Liu XX conducted a number of collation and statistical analysis; all the authors have read and approved the final manuscript.
Supported by Jiangsu Province Traditional Chinese Medicine Technology Development Plan Project, No. ZD201903; China Medical Education Association, No. 2022KTZ005.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of Jiangsu Provincial Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Traditional Chinese Medicine.
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xin-Xin Liu, MD, Doctor, Department of General Surger, Jiangsu Provincial Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Traditional Chinese Medicine, No. 155 Hanzhong Road, Qinhuai District, Nanjing 210029, Jiangsu Province, China. liuxinxin2929@163.com
Received: September 27, 2023
Peer-review started: September 27, 2023
First decision: October 24, 2023
Revised: November 10, 2023
Accepted: November 24, 2023
Article in press: November 24, 2023
Published online: December 27, 2023
Processing time: 91 Days and 0.1 Hours
Abstract
BACKGROUND

Low anterior resection syndrome (LARS) is one of the common postoperative complications in patients with rectal cancer, which seriously affects their postoperative recovery and quality of life (QoL). Electroacupuncture therapy is one of the characteristic therapies of traditional Chinese medicine. There are few reports on the prevention and treatment of LARS by electroacupuncture therapy.

AIM

To explore the clinical effectiveness of electroacupuncture in managing rectal cancer patients with postoperative LARS.

METHODS

A total of 50 patients with LARS after rectal cancer surgery were retrospectively selected as the research subjects. According to the treatment methods, they were divided into an observation group (n = 25) and a control group (n = 25). During the four-week treatment period, the control group received standard defecation function training, while the observation group received electroacupuncture care and traditional defecation function training. The anal pressure index (which includes anal resting pressure, anal systolic pressure, and maximum tolerable volume), European Organization of Research and Treatment of Cancer (EORTC) QoL C30 (QLQ-C30) score, LARS Scale (LARSS) score, Wexner anal incontinence scale score, Xu Zhongfa five-item 10-point scale score, and the occurrence of adverse reactions were compared between the two groups before and after treatment.

RESULTS

The experimental group showed considerably enhanced LARSS scores compared to those in the control group after four weeks of treatment. In the first week, second week, and fourth week, the LARSS score and Wexner anal incontinence scale score decreased, and the Xu Zhong method five-item 10-point scale score increased, with significant differences (P < 0.05). The experimental group showed substantial improvements in anal resting pressure, anal systolic pressure, and maximum tolerance volume after undergoing 4 wk of therapy in the untreated group (P < 0.05). The experimental group's QLQ-C30 score on the EORTC QoL questionnaire was higher than that of the control group during the 1st, 2nd, and 4th wk (P < 0.05). No significant variation between the groups in the frequency of adverse reactions (P > 0.05) was observed.

CONCLUSION

Electroacupuncture positively impacted LARS following rectal cancer surgery, effectively improving clinical symptoms and anal pressure indicators and patients’ standard of life.

Keywords: Electroacupuncture, Low anterior resection syndrome, Rectal cancer

Core Tip: Low anterior resection syndrome is a group of clinical syndromes that often occur in patients with rectal cancer after anus-preserving surgery, which seriously affects the postoperative rehabilitation effect of patients. Electroacupuncture therapy has the effects of improving immune function and regulating intestinal flora balance, but the prevention and treatment effect of anterior resection syndrome has not been reported in relevant literature. This study mainly analyzes the prevention and treatment effect of electroacupuncture on anterior resection syndrome, and provides a reference for clinical reduction of the incidence of anterior resection syndrome.