Abstract：
BACKGROUND: We aimed to verify the effectiveness of electroacupuncture on postoperative ileus prevention after abdominal surgery by meta-analysis and trial sequential analysis (TSA).
METHODS: From inception to May 14, 2024, PubMed, the Cochrane Library, Web of Science, and Embase databases were searched. TSA was used to determine an optimal sample size and control false-positive findings. The primary outcome was the time to first defecation (hours).
RESULTS: Fourteen studies were included, with 1105 participants. Meta-analysis and TSA revealed firm evidence for benefits that electroacupuncture shorted the time to first defecation (mean difference [MD] -12.73 h, I2 = 22%, P < 0.01), the time to first flatus (MD -7.03 h, I2 = 25%, P < 0.01), the time to start of sips of water (MD -12.02 h, I2 = 0%, P < 0.01), and the time to start of liquid diet (MD -12.97 h, I2 = 0%, P < 0.01) compared with usual care. While compared with sham electroacupuncture, meta-analysis and TSA also confirmed that electroacupuncture shortened the time to first defecation (MD -10.81 h, I2 = 31%, P = 0.02) and the time to first flatus (MD -10.81 h, I2 = 0%, P < 0.01). However, TSA revealed that firm evidence for benefit or futility was not reached for the length of hospital stay and the rates of postoperative prolonged ileus.
CONCLUSIONS: Electroacupuncture shortened the duration of postoperative ileus in patients undergoing abdominal surgery, and the adverse events related to electroacupuncture were minor. Further investigation of the effect of electroacupuncture on the risk of prolonged postoperative ileus is warranted in the future.
METHODS: From inception to May 14, 2024, PubMed, the Cochrane Library, Web of Science, and Embase databases were searched. TSA was used to determine an optimal sample size and control false-positive findings. The primary outcome was the time to first defecation (hours).
RESULTS: Fourteen studies were included, with 1105 participants. Meta-analysis and TSA revealed firm evidence for benefits that electroacupuncture shorted the time to first defecation (mean difference [MD] -12.73 h, I2 = 22%, P < 0.01), the time to first flatus (MD -7.03 h, I2 = 25%, P < 0.01), the time to start of sips of water (MD -12.02 h, I2 = 0%, P < 0.01), and the time to start of liquid diet (MD -12.97 h, I2 = 0%, P < 0.01) compared with usual care. While compared with sham electroacupuncture, meta-analysis and TSA also confirmed that electroacupuncture shortened the time to first defecation (MD -10.81 h, I2 = 31%, P = 0.02) and the time to first flatus (MD -10.81 h, I2 = 0%, P < 0.01). However, TSA revealed that firm evidence for benefit or futility was not reached for the length of hospital stay and the rates of postoperative prolonged ileus.
CONCLUSIONS: Electroacupuncture shortened the duration of postoperative ileus in patients undergoing abdominal surgery, and the adverse events related to electroacupuncture were minor. Further investigation of the effect of electroacupuncture on the risk of prolonged postoperative ileus is warranted in the future.
摘要：
背景：我们旨在通过荟萃分析和试验序贯分析（TSA）验证电针对腹部手术后肠梗阻预防的有效性。
方法：从成立到2024年5月14日，PubMed，Cochrane图书馆,WebofScience,搜索了Embase数据库。TSA用于确定最佳样本量和控制假阳性结果。主要结果是首次排便时间（小时）。
结果：纳入14项研究，1105人。荟萃分析和TSA揭示了确凿的证据，证明电针缩短了首次排便的时间（平均差异[MD]-12.73h，I2=22%，P<0.01),至首次排气的时间(MD-7.03h，I2=25%，P<0.01),开始喝水的时间(MD-12.02h，I2=0%，P<0.01),以及开始流质饮食的时间(MD-12.97h，I2=0%，P<0.01)与常规护理比较。而与假电针相比，荟萃分析和TSA还证实，电针缩短了首次排便的时间（MD-10.81h，I2=31%，P=0.02）和首次肛门排气时间（MD-10.81h，I2=0%，P<0.01)。然而,TSA显示，对于住院时间和术后长期肠梗阻的发生率，没有获得有效或无效的确凿证据。
结论：电针可缩短腹部手术患者术后肠梗阻的时间，与电针相关的不良事件轻微。将来有必要进一步研究电针对术后肠梗阻延长风险的影响。
方法：从成立到2024年5月14日，PubMed，Cochrane图书馆,WebofScience,搜索了Embase数据库。TSA用于确定最佳样本量和控制假阳性结果。主要结果是首次排便时间（小时）。
结果：纳入14项研究，1105人。荟萃分析和TSA揭示了确凿的证据，证明电针缩短了首次排便的时间（平均差异[MD]-12.73h，I2=22%，P<0.01),至首次排气的时间(MD-7.03h，I2=25%，P<0.01),开始喝水的时间(MD-12.02h，I2=0%，P<0.01),以及开始流质饮食的时间(MD-12.97h，I2=0%，P<0.01)与常规护理比较。而与假电针相比，荟萃分析和TSA还证实，电针缩短了首次排便的时间（MD-10.81h，I2=31%，P=0.02）和首次肛门排气时间（MD-10.81h，I2=0%，P<0.01)。然而,TSA显示，对于住院时间和术后长期肠梗阻的发生率，没有获得有效或无效的确凿证据。
结论：电针可缩短腹部手术患者术后肠梗阻的时间，与电针相关的不良事件轻微。将来有必要进一步研究电针对术后肠梗阻延长风险的影响。
