Table 1. Characteristics of included studies in the systematic review and meta-analysis.
| Study | Country | Sample size (M/F) | Ages (I/C) | Surgical approach | Control a | Intervention | Course of treatment | Outcomes |
|---|---|---|---|---|---|---|---|---|
| Xu 2020 [33] | China | I: 16/14 C: 15/15 |
I: 28.55 ± 9.75 C: 29.64 ± 9.34 |
Open | UC | EA | NA | TFF, TBSR, LOS |
| Gu 2019 [35] | China | I: 31/27 C: 29/30 |
I: 57.59 ± 7.32 C: 56.67 ± 6.23 |
Laparoscopic | SA | TEAS | From 30 min before anesthetic induction to 2 days after operation | TFF, TFD, TBSR, VAS, AC, Incidence of PONV, Patient satisfaction |
| Pu 2019 [34] | China | I: 20/11 C: 16/15 |
I: 55.07 ± 10.17 C: 56.13 ± 11.08 |
Open | UC | EA | 5 consecutive postoperative days | TFF, TFD, TBSR, LOS, PSA |
| Chen 2018 [36] | China | I: 22/11 C: 24/6 |
I: 63.0 ± 9.70 C: 59.0 ± 8.30 |
Open, laparoscopic | UC | TEAS | Starting on postoperative day 1, for 5 consecutive days or until passing flatus | TFF, TFD, LOS, TNTR, TLSD, PSA |
| Kang 2017 [39] | China | I: 39/29 C: 41/27 |
I: 41.28 ± 10.36 C: 40.75 ± 10.19 |
Unclear | UC | EA | NA | TFF, TFD, TBSR, LOS, ADL |
| Jung 2017 [40] | Korea | I: 16/2 C: 16/2 |
I: 60.94 ± 9.43 C: 60.06 ± 13.18 |
Open, laparoscopic | UC | EA | 5 consecutive postoperative days | TFF, TFD, LOS, SWI, SSD, the number of remnant sitz markers in the small intestine on abdominal radiograph |
| Yuan 2017 [37] | China | I: 12/18 C: 16/14 |
I: 53.9 ± 9.8 C: 54.6 ± 10.4 |
Laparoscopic | SA | TEAS | Half an hour before operation, then 3 consecutive postoperative days | TFF, TBSR, LOS, Incidence of PONV, AC |
| Qian 2017 [38] | China | I: 20/10 C: 17/13 |
I: 59 ±10 C: 60 ± 11 |
Unclear | UC | MA | 7 consecutive postoperative days | TBSR, TFF, LOS, TGTR, IPAR, QOL, Hospitalization expenses |
| Zhang 2014 [41] | China | I: 11/8 C: 11/9 |
I: 63 ± 9 C: 60 ± 10 |
Open | SA | EA | 30 min after operation, then 4 consecutive postoperative days | TFF, TFD, TBSR, |
| Xiao 2014 [42] | China | I: 18/12 C1: 19/11 C2: 14/16 |
I: 55.87 ± 10.49 C1: 55.33 ± 10.83 C2: 54.63 ± 10.25 |
Open | UC | I1: EA I2: MA |
5 consecutive postoperative days | TFF, TFD, TBSR, PSA |
| Tong 2014 [43] | China | I: 24/18 C: 26/16 |
I: 58.6 ± 15.1 C: 59.2 ± 14.7 |
Open | UC | MA | 2 consecutive postoperative days | TFF, TFD, TBSR, TLFI, TNTR, PSA |
| Wang 2013 [44] | China | I: 41/23 C: 43/21 |
I: 40.5 ± 9.7 C: 42.3 ± 9.1 |
Unclear | UC | MA | 10 consecutive postoperative days | TFF, TFD, TBSR |
| Ng 2013 [45] | China | I: 35/20 C1: 33/22 C2: 31/24 |
I: 67.4 ± 9.7 C1: 67.4 ± 10.7 C2: 68.5 ± 10.6 |
Laparoscopic | C1: UC C2: SA |
EA | Starting on postoperative day 1, for 4 consecutive days or until the first defecation | TFF, TFD, LOS, TTSD, TWI, VAS, AC |
| Shi 2012 [46] | China | I: 15/15 C: 17/13 |
I: 53.17 ± 13.491 C: 53.77 ± 13.320 |
Unclear | UC | EA | 3 consecutive postoperative days | TFF, TFD, TBSR, PSA |
| Yang 2011 [47] | China | I: 21/10 C: 18/11 |
I: 60.9 ± 6.63 C: 62 ± 6.98 |
Unclear | UC | EA | Starting on postoperative day 1 until 3 days after first defecation | TFF, TFD, TBSR |
| Wang 2011 [48] | China | I: 11/4 C: 9/6 |
I: 58.0 ± 10.24 C: 60.4 ± 11.01 |
Open | UC | MA | 5 consecutive postoperative days | TFF, TFD, TBSR, PSA |
| Meng 2010 [50] | China | M: 47 F: 38 |
I: 54.3 (mean) C: 53.1(mean) |
Unclear | UC | EA | Starting on postoperative day 1, for 6 consecutive days or until the first bowel movement | TFF, TFD, EGEG, QOL |
| Garcia 2008 [49] | America | I: 25/13 C: 26/14 |
35–45: 14 46–55: 24 56–65: 26 66–75: 12 75: 1 |
Unclear | UC | EA | Starting on postoperative day 1, for 4 consecutive days or until the first defecation | TFF, TFD, LOS, AC, QOL |
a Usual care included: routine nasogastric tubes, intravenous fluids, parenteral nutrition and early mobilization.
Abbreviations: I/C, Intervention group/Control group; M/F, Male/Female; MA, manual acupuncture; EA, electroacupuncture; TEAS, transcutaneous electrical acupoint stimulation; UC, usual care; SA, sham acupuncture; ERAS, enhanced recovery after surgery; NA, not available; TFF, time to first flatus; TBSR, time to bowel sounds recovery; LOS, length of hospital stay; TFD, time to first defecation; VAS, visual analogue scale; AC, analgesic consumption; PONV, postoperative nausea and vomiting; PSA, postoperative symptom assessment; TNTR, time to nasogastric tube removal; TLSD, time to liquid and semi-liquid diet; ADL, activities of daily living; SWI, start of water intake; SSD, start of soft diet; TGTR, time to gastric tube removal; IPAR, incidence of postoperative adverse reactions; QOL, quality of life status, including pain, nausea, insomnia, abdominal distention and general sense of well-being; TLFI, time to liquid food intake; TTSD, time to tolerated a solid diet; TWI, time to walk independently; EGEG, electro-gastroenterography.