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

doi:10.4240/wjgs.v15.i12.2765

Application of electroacupuncture in the prevention of low anterior resection syndrome after rectal cancer surgery

World J Gastrointest Surg. 2023 Dec 27;15(12):2765-2773. doi: 10.4240/wjgs.v15.i12.2765.

Authors

Lu-Lu Xu¹, Neng-Jun Xiang¹, Tian-Cheng Cheng¹, Yi-Xian Li¹, Peng Chen¹, Zhi-Wei Jiang², Xin-Xin Liu³

Affiliations

¹ The First Clinical Medical College, Nanjing University of Traditional Chinese Medicine, Nanjing 210023, Jiangsu Province, China.
² Department of General Surger, Jiangsu Provincial Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Traditional Chinese Medicine, Nanjing 210029, Jiangsu Province, China.
³ Department of General Surger, Jiangsu Provincial Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Traditional Chinese Medicine, Nanjing 210029, Jiangsu Province, China. liuxinxin2929@163.com.

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 1^st, 2^nd, and 4^th 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.