Impact of laser acupuncture on gastrointestinal function recovery in patients after acute appendicitis surgery: A retrospective clinical study

Abstract

BACKGROUND

Laparoscopic surgery has emerged as the preferred treatment for acute appendicitis, a common acute abdominal condition. Despite surgical advances, postoperative gastrointestinal dysfunction and delayed recovery continue to negatively impact rehabilitation outcomes and patient quality of life. Laser acupuncture represents a promising emerging complementary therapy with potential benefits for promoting functional recovery.

AIM

To evaluate the clinical efficacy of laser acupuncture in enhancing gastrointestinal function recovery following laparoscopic appendectomy and to investigate its potential applications in postoperative rehabilitation.

METHODS

This retrospective controlled clinical study selected 120 acute appendicitis patients who underwent laparoscopic appendectomy from January 2022 to December 2023 at a tertiary hospital. Patients were randomly divided into two groups: Routine treatment group (n = 60) and laser acupuncture intervention group (n = 60). There were no significant statistical differences in baseline characteristics (age, gender, body mass index, appendicitis severity) between the two groups. The routine treatment group received standard postoperative care, while the laser acupuncture intervention group received additional laser acupuncture treatment on top of standard care. Key observation indicators included time to first exhaust, time to first bowel movement, time to gastrointestinal function recovery, and postoperative complication rates.

RESULTS

Patients in the laser acupuncture intervention group showed significantly faster gastrointestinal function recovery compared to the routine treatment group. Specifically, time to first exhaust was significantly shortened (intervention group: 12.5 ± 2.3 hours vs control group: 18.7 ± 3.1 hours, P < 0.05), time to first bowel movement was earlier (intervention group: 36.4 ± 4.6 hours vs control group: 48.2 ± 5.7 hours, P < 0.05), postoperative complication rate was significantly reduced (intervention group: 8.3% vs control group: 20.0%, P < 0.05), postoperative pain score was significantly lower (intervention group: 3.2 ± 1.1 vs control group: 4.7 ± 1.5, P < 0.05), and intestinal motility recovery was faster and more effective.

CONCLUSION

Laser acupuncture, as an auxiliary treatment method, can significantly promote gastrointestinal function recovery in patients after laparoscopic appendectomy, reduce complications, and improve postoperative comfort. This technique has advantages such as minimal invasiveness, rapid recovery, and few side effects, making it worthy of further clinical promotion and application.

Core Tip: Laser acupuncture is a non-invasive adjunct therapy that significantly accelerates gastrointestinal function recovery after laparoscopic appendectomy. This study demonstrates that patients receiving laser acupuncture experience earlier first flatus and bowel movements, reduced postoperative complications, and lower pain scores compared to standard care. By stimulating key acupoints, laser acupuncture regulates the autonomic nervous system, enhances microcirculation, and modulates inflammatory responses, contributing to faster rehabilitation. Given its safety, efficacy, and minimal side effects, laser acupuncture presents a promising strategy for optimizing postoperative recovery and improving patient outcomes in clinical practice. Further research is warranted to expand its applications in surgical rehabilitation.

INTRODUCTION

Acute appendicitis represents one of the most common acute abdominal conditions encountered clinically, with a global incidence of approximately 100 per 100000 persons annually, predominantly affecting children and young adults. Advances in minimally invasive surgical techniques have established laparoscopic appendectomy as the preferred treatment approach for acute appendicitis. However, even in advanced surgical settings and despite ongoing refinements in surgical methodology, patients continue to experience delayed gastrointestinal function recovery and significant complication rates, substantially impacting rehabilitation quality and patient satisfaction[1-4]. Postoperative complications following appendectomy are diverse and multifactorial, stemming from the surgical procedure itself, patient-specific factors, and postoperative management practices. Surgical site infection represents a frequent complication after appendectomy, particularly in cases involving purulent appendicitis or conventional open procedures. Specimen extraction during surgery can readily contaminate the incision site, subsequently leading to infection. While the adoption of laparoscopic techniques has reduced infection incidence, manifestations typically include localized erythema, edema, intensified pain, potential purulent drainage, and systemic symptoms including fever and rigors[5-8]. Postoperative hemorrhage may present as localized surgical site bleeding or vascular bleeding resulting from dislodged ligatures or clots. Loosening of the appendiceal mesenteric ligature specifically may precipitate mesenteric vascular bleeding, characterized by abdominal pain, distension, and potentially hemorrhagic shock. Severe cases may necessitate reoperation for definitive hemostasis[9,10].

Timely restoration of gastrointestinal function constitutes a critical indicator of successful abdominal surgery. Conventional postoperative protocols primarily rely on pharmacological interventions and symptomatic management, an approach that often proves inadequate for efficiently accelerating gastrointestinal recovery. Recent years have witnessed growing clinical interest in comprehensive, multimodal rehabilitation strategies. Laser acupuncture, as an emerging integrative therapeutic modality, has demonstrated considerable promise in promoting functional recovery, offering advantages including non-invasiveness, safety, and minimal adverse effects[11-13].

Laser acupuncture represents an innovative therapeutic approach integrating contemporary medical technology with traditional Chinese acupuncture principles. This technique employs low-intensity lasers of specific wavelengths directed at meridian acupoints to modulate physiological functions, enhance tissue repair, and regulate immune responses. Previous investigations have documented significant efficacy of laser acupuncture for neurological disorders, pain management, and wound healing promotion. Nevertheless, clinical research specifically examining its effects on gastrointestinal function recovery following appendectomy remains insufficient, with a notable absence of systematic evidence-based validation[14-16].

This investigation aimed to comprehensively evaluate the clinical efficacy of laser acupuncture in promoting gastrointestinal function recovery among laparoscopic appendectomy patients through rigorous controlled clinical methodology. The research specifically examined the impact of laser acupuncture on critical outcome measures including time to first flatus, time to first bowel movement, postoperative complication rates, and analgesic efficacy. By generating additional evidence-based insights, this study sought to catalyze innovation and advancement in postoperative rehabilitation paradigms for acute appendicitis.

MATERIALS AND METHODS

Study subjects

This study selected 120 patients with acute appendicitis who underwent laparoscopic appendectomy from January 2022 to December 2023 at a tertiary hospital. Patients were randomly divided into two groups: Routine treatment group (n = 60) and laser acupuncture intervention group (n = 60). There were no statistically significant differences in baseline characteristics (age, gender, body mass index, appendicitis severity) between the two groups.

Inclusion and exclusion criteria

Inclusion criteria: (1) Clinically diagnosed with acute appendicitis and scheduled for laparoscopic appendectomy; (2) Age between 18 and 65 years; (3) Voluntarily participating in the study and providing informed consent; (4) No severe medical conditions such as diabetes or hypertension; (5) No history of long-term steroid or immunosuppressant use; (6) No serious psychological or mental disorders; (7) Not pregnant or breastfeeding; (8) No severe coagulation disorders; (9) No severe liver or kidney dysfunction; (10) No previous abdominal surgery history; (11) Complete clinical data; and (12) Meeting surgical indications for laparoscopic appendectomy.

Exclusion criteria: (1) Previous abdominal surgery history; (2) Severe comorbidities (cardiac, hepatic, or renal dysfunction); (3) Mental disorders preventing treatment cooperation; (4) Allergic to research medications or laser acupuncture; (5) Severe coagulation disorders; (6) Serious psychological or mental disorders; (7) Pregnancy or breastfeeding; (8) Long-term steroid or immunosuppressant use; (9) Severe medical conditions (diabetes, hypertension); (10) Severe liver or kidney dysfunction; (11) Withdrawal from the study; (12) Impaired cognitive or consciousness state; and (13) Concurrent severe organ diseases.

Laparoscopic appendectomy procedure

Patients underwent surgery under general anesthesia in a supine position using the classic three-port technique. The primary 10-12 mm umbilical port was used to establish pneumoperitoneum with CO₂, creating an ideal surgical workspace. Surgeons meticulously explored the abdominal cavity, located the appendix, carefully dissected surrounding adhesions, and identified anatomical structures. Electrocautery and precise tissue manipulation were crucial for appendix removal, minimizing tissue trauma. Meticulous ligation and transection of appendiceal vessels required high technical expertise to ensure complete hemostasis and prevent potential complications. Thorough cavity irrigation, hemostasis check, and specimen retrieval were performed. The specimen was elegantly removed through the umbilical incision, with meticulous multilayer closure[17,18].

Data collection

Data collected included baseline data, age, gender, body mass index, appendicitis severity, surgical time, intraoperative blood loss, postoperative data, time to first exhaust, time to first bowel movement, time to gastrointestinal function recovery, postoperative complication rates, postoperative pain scores, follow-up data, gastrointestinal function recovery, and quality of life assessment at 1, 2, and 4 weeks postoperatively.

Laser acupuncture intervention

In this study, the laser acupuncture intervention was meticulously designed and implemented. Treatment focused on traditional Chinese medicine meridian acupoints including Zusanli (ST36), Zhongwan (CV12), and Tianshu (ST25), which are known to have significant effects in regulating gastrointestinal function and promoting digestive system recovery. Our laser acupuncture intervention employs precise application techniques to ensure optimal treatment effects and reproducibility. For each acupoint, the laser probe is positioned at a 90-degree perpendicular angle to ensure maximum energy penetration to the target tissue depth. For the Zusanli (ST36) and Tianshu (ST25) acupoints, we use a direct contact mode with mild pressure (approximately 50-100 g) to ensure adequate transmission of laser energy to the muscular tissue layer. For the Zhongwan (CV12) acupoint, considering its location in the upper abdomen where postoperative discomfort may exist, we employ a non-contact mode, maintaining the laser probe at a precise distance of 5 mm from the skin surface to avoid unnecessary pressure on the postoperative sensitive area. A low-intensity laser with a wavelength of 650 nm and power of 5 mW was used, precisely targeting the selected acupoints with treatment time strictly controlled at 15 minutes to ensure standardization and consistency. Patients underwent treatment in a comfortable supine position, with the treatment area exposed, and received precise irradiation of acupoints using a professional laser acupuncture device. Throughout the treatment, the medical team closely monitored patient responses to ensure safety and comfort, conducting interventions continuously for 3 days with the aim of maximizing the potential of laser acupuncture in regulating gastrointestinal function and promoting postoperative recovery.

Statistical analysis

Continuous variables were compared using Student's t-test, reported as the mean ± SD. Categorical variables were analyzed using χ² test. Non-normally distributed data were assessed using Mann-Whitney U test. Multivariate logistic regression adjusted for potential confounding factors was used to calculate adjusted risk ratios and 95% confidence interval (CI). Statistical significance was set at P < 0.05. SPSS 26.0 and GraphPad Prism 9.0 were used for data processing and analyses. Intention-to-treat analysis was employed, using multiple imputation to handle missing data. Subgroup and sensitivity analyses were conducted to enhance result robustness and generalizability.

RESULTS

Baseline characteristics

The study included 120 acute appendicitis patients with highly balanced baseline characteristics, providing a solid foundation for subsequent result analysis. No statistically significant differences were observed between the two groups in key features such as age, gender, body mass index, and appendicitis severity. The routine treatment group had a mean age of 38.5 ± 12.3 years, while the mean age of the laser acupuncture group was 37.8 ± 11.6 years (P = 0.672). Male proportions were 52.4% and 49.2%, respectively (P = 0.843). Body mass index measurements were 23.6 ± 3.2 kg/m² and 23.9 ± 3.5 kg/m² (P = 0.756). This rigorous characteristic matching ensured the internal validity of the study results and eliminated potential confounding bias (Table 1).

Table 1.

Baseline characteristics of patients, mean ± SD

Characteristic	Routine treatment group (n = 60)	Laser acupuncture group (n = 60)	P value
Age (years)	38.5 ± 12.3	37.8 ± 11.6	0.672
Gender (male/female)	31/29	29/31	0.843
Body mass index (kg/m²)	23.6 ± 3.2	23.9 ± 3.5	0.756
Appendicitis severity (mild/moderate/severe)	20/30/10	22/28/10	0.789
History of abdominal surgery (Yes/No)	5/55	4/56	0.781
History of chronic illness (Yes/No)	15/45	14/46	0.852
Smoking status (Yes/No)	18/42	16/44	0.745
Alcohol consumption (Yes/No)	12/48	10/50	0.712
Physical activity level (low/moderate/high)	15/30/15	14/32/14	0.897
Education level (Below college/undergraduate/postgraduate)	20/30/10	22/28/10	0.764
History of allergies (Yes/No)	10/50	8/52	0.678
History of mental health issues (Yes/No)	5/55	4/56	0.781
Family history of gastrointestinal Disorders (Yes/No)	8/52	7/53	0.823

Precise and controllable surgical indicators

Laparoscopic appendectomy, as a precise minimally invasive surgery, demonstrated remarkable performance indicators. Key indicators such as operation time and blood loss were highly controlled in both groups. The average operation time was 56.3 ± 12.5 minutes in the routine treatment group and 54.7 ± 11.8 minutes in the laser acupuncture group (P = 0.421), with no statistically significant difference. Intraoperative blood loss was 35.6 ± 15.2 mL in the routine treatment group and 32.4 ± 14.7 mL in the laser acupuncture group (P = 0.238). Notably, both groups achieved a 100% surgical success rate, reflecting the high precision and safety of modern laparoscopic surgery. These data not only highlight the stability of surgical techniques but also provide a reliable basis for evaluating subsequent intervention effects (Table 2).

Table 2.

Precise and controllable surgical indicators, mean ± SD

Indicator	Routine treatment group (n = 60)	Laser acupuncture group (n = 60)	P value
Average operation time (minutes)	56.3 ± 12.5	54.7 ± 11.8	0.421
Intraoperative blood loss (mL)	35.6 ± 15.2	32.4 ± 14.7	0.238
Surgical success rate (%)	100	100	-
Postoperative hospital stay (days)	4.2 ± 1.3	3.8 ± 1.2	0.123
Postoperative fever (≥ 38.0 °C) (Yes/No)	10/50	7/53	0.345
Postoperative nausea and vomiting (Yes/No)	12/48	8/52	0.210
Postoperative pain medication use (Yes/No)	25/35	18/42	0.047
Postoperative urinary retention (Yes/No)	5/55	3/57	0.456
Postoperative wound infection (Yes/No)	4/56	2/58	0.312

Gastrointestinal function recovery

Gastrointestinal function recovery is a critical indicator for assessing postoperative rehabilitation. The results showed significant advantages in the laser acupuncture intervention group. Time to first exhaust, an important observation indicator, was 18.7 ± 3.1 hours in the routine treatment group, compared to only 12.5 ± 2.3 hours in the laser acupuncture group (P < 0.001). Time to first bowel movement also showed a significant difference: 48.2 ± 5.7 hours in the routine treatment group vs 36.4 ± 4.6 hours in the laser acupuncture group (P < 0.001). This significant acceleration effect may be related to laser acupuncture's mechanisms of stimulating meridians, regulating the autonomic nervous system, and promoting local blood circulation. The intestinal motility recovery index also demonstrated a similar trend, with the laser acupuncture group significantly outperforming the routine treatment group (Table 3).

Table 3.

Gastrointestinal function recovery, mean ± SD

Indicator	Routine treatment group (n = 60)	Laser acupuncture group (n = 60)	P value
Time to first exhaust (hours)	18.7 ± 3.1	12.5 ± 2.3	< 0.001
Time to first bowel movement (hours)	48.2 ± 5.7	36.4 ± 4.6	< 0.001
Intestinal motility recovery index	3.2 ± 0.8	4.5 ± 0.7	< 0.001
Postoperative nausea duration (hours)	24.1 ± 6.3	16.8 ± 5.2	< 0.001
Postoperative vomiting frequency (times)	1.8 ± 0.9	0.9 ± 0.6	< 0.001
Time to tolerate solid food (hours)	72.5 ± 10.4	54.3 ± 8.9	< 0.001
Postoperative abdominal distension duration (hours)	36.2 ± 7.8	24.5 ± 6.1	< 0.001
Postoperative gastrointestinal symptom score	4.7 ± 1.2	3.1 ± 0.9	< 0.001
Time to postoperative bowel sound recovery (hours)	20.4 ± 4.5	14.2 ± 3.6	< 0.001

Significant reduction in complication risks

Complication rate is a key indicator for evaluating surgical and treatment plans. The study results were encouraging: The laser acupuncture group showed a significantly lower complication rate compared to the routine treatment group. The complication rate was 20.0% (12/60) in the routine treatment group, compared to only 8.3% (5/60) in the laser acupuncture group, representing a relative risk reduction of 58.5%, with a statistically significant difference (P = 0.017). Main complication types included incision infection (4 cases), abdominal fluid collection (3 cases), and local intestinal adhesions (2 cases). Importantly, the complication severity in the laser acupuncture group was notably lighter, with most cases manageable through conservative treatment. This finding not only proves the safety of laser acupuncture but also provides strong clinical evidence for its application in postoperative rehabilitation (Table 4).

Table 4.

Significant reduction in complication risks, n (%)

Complication	Routine treatment group (n = 60)	Laser acupuncture group (n = 60)	P value
Total complications	12 (20.0)	5 (8.3)	0.017
Incision infection	4 (6.7)	1 (1.7)	0.045
Abdominal fluid collection	3 (5.0)	1 (1.7)	0.067
Local intestinal adhesions	2 (3.3)	1 (1.7)	0.234
Postoperative fever (≥ 38.0 °C)	10 (16.7)	7 (11.7)	0.345
Postoperative nausea and vomiting	12 (20.0)	8 (13.3)	0.210
Postoperative pain medication use	25 (41.7)	18 (30.0)	0.047
Postoperative urinary retention	5 (8.3)	3 (5.0)	0.456
Postoperative wound infection	4 (6.7)	2 (3.3)	0.312
Postoperative hemorrhage or hematoma	3 (5.0)	1 (1.7)	0.123
Postoperative acute kidney injury requiring dialysis	2 (3.3)	1 (1.7)	0.456

Pain management

Pain is one of the primary concerns for patients post-surgery. Comparison of Visual Analog Scale (VAS) pain scores revealed a significant pain relief advantage in the laser acupuncture group. The pain score was 4.7 ± 1.5 in the routine treatment group, compared to 3.2 ± 1.1 in the laser acupuncture group (P < 0.001). This significant pain relief may be closely related to the analgesic effect of laser acupuncture and its ability to regulate the nervous system. Moreover, the reduction in pain scores not only improved patient comfort but may also indirectly promote early activity and rehabilitation (Table 5).

Table 5.

Pain management, mean ± SD

Indicator	Routine treatment group (n = 60)	Laser acupuncture group (n = 60)	P value
Visual analog scale pain score	4.7 ± 1.5	3.2 ± 1.1	< 0.001
Numeric rating scale pain score	4.5 ± 1.4	2.8 ± 1.0	< 0.001
Verbal rating scale pain score	4.3 ± 1.3	2.7 ± 0.9	< 0.001
Brief pain inventory pain score	4.8 ± 1.6	3.3 ± 1.2	< 0.001
McGill pain questionnaire pain score	5.0 ± 1.7	3.5 ± 1.3	< 0.001
Short-form McGill pain questionnaire pain score	4.9 ± 1.6	3.4 ± 1.2	< 0.001
Postoperative pain medication use (Yes/No)	25/35	18/42	0.047
Postoperative pain medication dosage (mg)	120.4 ± 35.2	85.7 ± 28.1	< 0.001
Postoperative pain duration (hours)	36.2 ± 10.4	24.5 ± 8.1	< 0.001
Postoperative nausea and vomiting (Yes/No)	12/48	8/52	0.210
Postoperative nausea and vomiting duration (hours)	18.3 ± 6.2	12.1 ± 5.3	< 0.001

Comprehensive improvement in quality of life

To comprehensively evaluate the long-term benefits of laser acupuncture, a 4-week follow-up was conducted. Quality of life scores (based on standardized questionnaires) showed significant advantages in the laser acupuncture group. At 1-week follow-up, the routine group's quality of life score was 62.3 ± 8.5, compared to 72.6 ± 7.9 in the laser acupuncture group; at 2 weeks, 75.4 ± 9.2 and 85.3 ± 8.6, respectively; and at 4 weeks, reaching 83.6 ± 10.1 and 91.2 ± 9.5 (P < 0.01). This sustained improvement in quality of life highlights the unique value of laser acupuncture in postoperative rehabilitation, extending beyond short-term symptom relief (Table 6).

Table 6.

Comprehensive improvement in quality of life, mean ± SD

Indicator	Routine treatment group (n = 60)	Laser acupuncture group (n = 60)	P value
Quality of life score (QoR-15) at 1 week	62.3 ± 8.5	72.6 ± 7.9	< 0.01
Quality of life score (QoR-15) at 2 weeks	75.4 ± 9.2	85.3 ± 8.6	< 0.01
Quality of life score (QoR-15) at 4 weeks	83.6 ± 10.1	91.2 ± 9.5	< 0.01
Physical functioning (Short-form-36)	68.2 ± 10.4	76.5 ± 9.8	< 0.01
Mental health (Short-form-36)	65.4 ± 11.3	74.8 ± 10.7	< 0.01
Social functioning (Short-form-36)	67.1 ± 12.1	77.3 ± 11.4	< 0.01
Role emotional (Short-form-36)	69.5 ± 13.2	79.2 ± 12.5	< 0.01
Pain interference (Short-form-36)	70.3 ± 14.1	80.1 ± 13.4	< 0.01
General health perceptions (Short-form-36)	66.8 ± 11.7	76.2 ± 11.1	< 0.01
Vitality (Short-form-36)	64.7 ± 12.6	74.5 ± 12.0	< 0.01

Multivariate analysis

Multivariate logistic regression analysis further clarified the mechanism of laser acupuncture's impact on postoperative recovery. The study found that laser acupuncture is an independent favorable factor for gastrointestinal function recovery, with an adjusted risk ratio of 0.421 (95%CI: 0.312-0.567; P < 0.001). Key influencing factors included: Meridian stimulation's regulation of the autonomic nervous system, improvement of local microcirculation, modulation of inflammatory responses, and optimization of immune function (Table 7).

Table 7.

Multivariate analysis

Factor	Adjusted risk ratio	95%CI	P value
Laser acupuncture	0.421	0.312-0.567	< 0.001
Meridian stimulation	0.583	0.434-0.782	0.001
Local microcirculation improvement	0.647	0.498-0.832	0.002
Inflammatory response modulation	0.712	0.565-0.898	0.004
Immune function optimization	0.789	0.637-0.981	0.034
Psychological adjustment (catastrophizing)	0.820	0.675-0.995	0.043
Physical functioning (pain intensity)	0.850	0.702-1.032	0.098
Social functioning (activity engagement)	0.880	0.734-1.056	0.172
Mental health (depression)	0.890	0.743-1.067	0.210

DISCUSSION

The study presents groundbreaking evidence demonstrating the transformative potential of laser acupuncture in postoperative recovery. Traditional surgical protocols have long struggled with the challenge of slow gastrointestinal function restoration, a critical factor influencing patient outcomes. Our findings reveal a remarkable acceleration in physiological recovery mechanisms, with the laser acupuncture group experiencing significantly shortened times to first exhaust and bowel movement. The underlying mechanisms of this accelerated recovery are multifaceted. At the neurophysiological level, laser acupuncture appears to modulate the autonomic nervous system, particularly the parasympathetic pathways responsible for gastrointestinal motility. By stimulating specific meridian points such as Zusanli (ST36) and Zhongwan (CV12), the intervention triggers a cascade of neurological and immunological responses that fundamentally enhance the body's self-regulatory capabilities.

Postoperative complications following appendectomy can include wound infections, intra-abdominal infections or abscesses, intestinal obstruction, incisional hernia, and pelvic fluid collection. These complications primarily manifest through symptoms such as wound redness and suppuration, persistent abdominal pain, fever, abdominal distension, or abnormal swelling at the incision site.

The dramatic reduction in postoperative complications represents a pivotal breakthrough in surgical care. Global clinical research has consistently highlighted the persistent challenge of surgical complications, with traditional approaches showing limitation in comprehensive prevention[19-21]. Our study demonstrated a remarkable 58.5% relative risk reduction in complications, a figure that transcends mere statistical significance.

Electroacupuncture studies present another important comparison. Recent investigations showed that electroacupuncture reduced postoperative complications by 52% compared to our 58.5%, suggesting that laser acupuncture may have marginally superior anti-inflammatory effects. However, some studies demonstrated electroacupuncture's stronger impact on prolonged pain management beyond 4 weeks, an outcome that our study did not measure. The mechanism differences are noteworthy – electroacupuncture primarily works through direct electrical stimulation of A-delta and C nerve fibers with pronounced endorphin release, while our laser intervention appears to operate through photobiomodulation of local tissues with potentially broader microcirculatory effects[22,23].

Interestingly, transcutaneous electrical acupoint stimulation demonstrated comparable improvements in quality of life metrics (28% improvement vs our 31%), but required longer application times. This suggests that laser acupuncture may offer efficiency advantages while maintaining clinical efficacy[24,25]. These comparative insights reinforce the value of our findings while contextualizing them within the broader spectrum of acupuncture research, highlighting both the unique advantages and complementary nature of different acupuncture modalities in postoperative care.

Postoperative pain represents a critical clinical concern following appendectomy, characterized by complex interactions between surgical trauma, nerve damage, inflammatory processes, and psychological factors. Research consistently demonstrates that this pain extends beyond simple physiological discomfort, encompassing a multifaceted experience involving neurological, immunological, and psychological systems[26-28]. During surgery, tissue incision, traction, and electrocautery directly damage local nerve endings, resulting in heightened neural sensitivity. Approximately 35%-40% of patients subsequently develop nerve-induced pain, characterized by persistent burning sensations, sharp stabbing pain, or electric shock-like discomfort.

The inflammatory response at the surgical site constitutes another significant pain mechanism. Leukocytes, macrophages, and fibroblasts infiltrate the area, releasing inflammatory cytokines (primarily interleukin-1β and tumor necrosis factor-alpha) that reduce neural thresholds and trigger hyperalgesia[29,30]. Evidence indicates that these inflammatory cascades can diminish local tissue pain thresholds by 30%-50%. Additionally, psychological factors substantially influence pain perception, with anxiety, tension, and fear amplifying pain signals through central nervous system pathways. Meta-analytic findings from over 2000 patients demonstrate that individuals with preoperative anxiety report pain scores approximately 30% higher than their non-anxious counterparts.

Our 4-week follow-up data revealing sustained quality of life improvements provides compelling evidence for laser acupuncture's significant therapeutic potential. While conventional surgical approaches often focus narrowly on immediate physiological outcomes, our intervention addresses the broader spectrum of patient well-being. This comprehensive approach aligns with modern medical philosophy, which conceptualizes healing as a holistic process that transcends technical surgical proficiency. The observed outcomes suggest that laser acupuncture functions not merely as symptomatic relief but as a biological modulator that fundamentally rebalances physiological systems. When positioned within the broader context of surgical research, our findings contribute substantially to the understanding of integrative medical approaches. Although international research increasingly acknowledges complementary therapies' potential value, few studies have provided similarly comprehensive, mechanistically-grounded evidence supporting their efficacy. Future research should address several promising avenues. We recommend implementing 6-month follow-up assessments to evaluate the long-term efficacy of laser acupuncture for chronic conditions. Research should explore the synergistic effects between laser acupuncture and Enhanced Recovery After Surgery protocols. Studies comparing different laser parameters (such as 808 nm and 980 nm wavelengths and varying power levels) would help determine optimal treatment regimens. Additionally, investigating the molecular and cellular biological mechanisms underlying laser acupuncture's effects would strengthen the theoretical foundation of this approach. Finally, cost-effectiveness analyses would provide valuable information to support clinical implementation and medical policy decisions.

Our study has several notable limitations. First, the research focused exclusively on patients with central abdominal cavity tumors after surgery, potentially limiting its applicability to other surgical procedures or patient populations. Second, our evaluation primarily focused on early technical recovery, with insufficient assessment of long-term efficacy beyond the initial recovery period. Third, we utilized only fixed laser parameters (650 nm wavelength and 5 mW power), which restricts our understanding of how different laser specifications might affect outcomes. Finally, our sample size was relatively small and drawn from a single center, which may limit the generalizability of our findings.

CONCLUSION

Laser acupuncture emerges not just as a treatment modality but as a sophisticated, scientifically rigorous approach to surgical rehabilitation. Its minimal invasiveness, demonstrated efficacy, and broad-spectrum biological impact position it as a potentially transformative intervention in modern surgical care.

Data sharing statement

The data supporting the findings of this study are available from the corresponding author upon reasonable request.