Effect of Electroacupuncture on Improving Gastrointestinal Motility in Patients After Gastrectomy: A Systematic Review and Meta-Analysis of randomized controlled trials.

Silva Neto, M.R.; Werner, C,  Neves, L.C.; Torres, R.V.; Dumont, L.; Ricci, M.; Dias, H.; Donato, G.; Dias, H.; González, G.L.; Vergna, R.D.; Lenzi, M.C.; do Nascimento, T.S. 

INTRODUCTION:  

Gastrointestinal immobility is common after gastric surgery and is associated with delayed enteral nutrition, prolonged hospital stay, and patient discomfort. Electroacupuncture (EA) is a widely used nonpharmacological therapy for gastrointestinal dysmotility. This study evaluated the effects of EA on postoperative gastrointestinal immobility following gastrectomy.

METHODS: 

PubMed, Cochrane Library, and Embase were searched from inception through December 2025. Studies published in English or Chinese were included without restrictions on year, region, or country. Eligible studies were randomized controlled trials (RCTs) enrolling hospitalized adults (>18 years) after gastric surgery. Random-effects models were used for data synthesis, and heterogeneity was explored through subgroup analyses. Statistical analyses were performed using Review Manager version 5.4.

RESULTS:

Four RCTs involving 596 participants were included. Compared with SHAM care, EA significantly reduced time to gastrointestinal recovery. In control groups, time to first flatus ranged from 46.8 ± 18.79 to 82.08 ± 30.45 hours, and time to recovery of bowel sounds ranged from 22.73 ± 12.88 to 41.3 ± 4.74 hours. In EA groups, time to first flatus ranged from 40.87 ± 12.22 to 69.46 ± 25.43 hours, and recovery of bowel sounds ranged from 13.85 ± 8.07 to 34.13 ± 11.33 hours. In the EA versus SHAM comparison, EA demonstrated a significant reduction in outcome measures (mean difference [MD] −10.91; 95% confidence interval [CI] −14.51 to −7.31; p < 0.00001), with no observed heterogeneity (Chi² p = 0.54; I² = 0%). Similarly, comparison with standard care favored EA (MD −8.74; 95% CI −10.95 to −6.54; p < 0.00001), again with negligible heterogeneity (Chi² p = 0.44; I² = 0%), indicating consistent effects across studies.

Figure 2: Meta-analysis of bowel sound recovery: EA vs. SHAM. Electroacupuncture significantly reduced recovery time (P<0.00001; I²=0%).

Figure 3: Meta-analysis of time to first flatus: EA vs. SHAM. Electroacupuncture significantly shortened recovery time ($P < 0.00001$; $I^2 = 0\%$)

DISCUSSION

Electroacupuncture improved postoperative gastrointestinal recovery after gastrectomy and was more effective than SHAM or standard care in the included RCTs. With appropriate training or supervision, healthcare professionals can safely administer EA as part of postgastrectomy care, using commonly applied electrical acupoints to enhance gastrointestinal motility. Clinical relevance: Electroacupuncture may be incorporated into routine postgastrectomy care to accelerate gastrointestinal recovery and reduce time to return of bowel sounds.

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