Electrical acupoint stimulation for gastrointestinal recovery after gastrectomy for gastric cancer: a systematic review and meta-analysis
In brief
Electrical acupoint stimulation was linked to first flatus about 10 hours sooner
In randomized trials after stomach cancer surgery, electrical acupoint stimulation was associated with first flatus about 10 hours earlier; findings also favored earlier bowel movements and liquid intake. But evidence for the main outcome was very low certainty, publication bias was a concern, and hospital stays were not significantly shorter, so the clinical benefit remains uncertain.
- Journal
- Frontiers in surgery (Q2)
- Published
- 16 September 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- Dong-Hyeon Oh, Yong-Eun Park, Hyun Dong Chae
- PMID
- 42819384
- DOI
- 10.3389/fsurg.2026.1915755
Why clinicians should know about it
- Picked for Anatomy (top studies of the week, 4 October 2026).
Abstract
Delayed gastrointestinal recovery remains a challenge after gastrectomy for gastric cancer, with residual variability even within enhanced recovery after surgery (ERAS) pathways. This residual variability has prompted interest in adjunctive approaches such as electrical acupoint stimulation (EAS), but gastrectomy-specific anatomical and neural features may limit extrapolation from broader abdominal-surgery populations. We therefore synthesized randomized evidence on EAS for postoperative gastrointestinal recovery and examined variation across study-level characteristics. We searched PubMed, Embase, Scopus, CENTRAL, China National Knowledge Infrastructure, Wanfang Data, SinoMed, and four registries from inception to a 1 August 2026 cutoff. We included randomized trials in patients undergoing gastrectomy for gastric cancer when EAS was separable from other traditional or acupoint-based co-interventions. Outcomes were time to first flatus (primary), first defecation, first liquid intake, and length of hospital stay. Safety was summarized descriptively. Risk of bias was assessed with the Cochrane Risk of Bias 2 tool and certainty with GRADE; exploratory subgroup differences were examined using interaction tests. Fifteen trials were eligible; 13 contributed to the primary pairwise comparison (1,357 participants) and two to narrative synthesis only. EAS was associated with shorter times to first flatus [13 trials; mean difference (MD), -9.61 h; 95% CI, -12.81 to -6.42; I 2 = 82.6%; very low certainty], first defecation (9 trials; MD, -15.88 h; 95% CI, -23.31 to -8.46; I 2 = 90.3%; low certainty), and first liquid intake (2 trials; MD, -10.65 h; 95% CI, -18.20 to -3.10; I 2 = 0%; low certainty). Length of hospital stay did not differ significantly (7 trials; MD, -0.63 days; 95% CI, -1.36 to 0.10; I 2 = 57.0%; low certainty). Prediction intervals narrowly excluded the null for flatus but included it for defecation. For flatus, funnel-plot asymmetry and trim-and-fill attenuation raised publication-bias concerns. None of the 12 primary interaction tests across comparator design, perioperative care, stimulation modality, and frequency strategy was significant. Safety reporting was limited; no serious intervention-related adverse events were reported where assessed. Current evidence indicates a consistent directional signal favoring EAS for early postoperative gastrointestinal recovery milestones, but the magnitude, reproducibility, and clinical importance of this association remain uncertain. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420261289414, identifier CRD420261289414.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.