A systematic review and meta-analysis of acupuncture versus sham/placebo acupuncture for postoperative gastrointestinal dysfunction in cancer patients: Evidence from randomized controlled trials

Background: – Acupuncture has been found to be an effective treatment for postoperative gastrointestinal dysfunction (PGD). Nonetheless, it remains uncertain if acupuncture possesses a placebo effect. This study compared the efficacy and safety of acupuncture against sham/placebo acupuncture for PGD in cancer. Methods: – We comprehensively searched the Central Register of Controlled Trials of 8 databases from database inception through August 31, 2024 for randomized controlled trials that compared acupuncture therapy with sham/placebo acupuncture. Cochrane risk of bias tool (version 2 of the Cochrane risk of bias tool [RoB2]) was used to analyze risk of bias. Data analysis was performed with Review Manager 5.4, Stata 12.0 software was used to test the publication bias. Results: – Eleven randomized controlled trials involving 1923 patients were included in this study. Meta-analysis results showed that acupuncture therapy was superior to sham/placebo acupuncture in terms of improving time to first flatus (TFF), time to first defecation (TFD), time to bowel sound recovery, length of hospital stay (LOS). The subgroup analysis based on the type of acupuncture and sham acupuncture showed that transcutaneous electrical acupoint stimulation could significantly reduce the TFF, LOS, TFD, and time to bowel sound recovery; electroacupuncture could significantly reduce the TFF and TFD, and there was no significant statistical difference between electroacupuncture and sham acupuncture in LOS. No trial reported severe adverse events of acupuncture. Conclusions: – The results of this study indicate that acupuncture shown greater efficacy than sham/placebo acupuncture in the treatment of PGD in cancer. Acupuncture appeared safe, but adverse events were underreported.