Effect of laser acupuncture on adhesive small bowel obstruction: A prospective double-blind randomized controlled trial

Chun-Han Shih, Ting-Min Hsieh, Bei-Yu Wu, Chun-Ting Liu, Chun-Han Shih, Ting-Min Hsieh, Bei-Yu Wu, Chun-Ting Liu

Abstract

Background: Adhesive small bowel obstruction (ASBO) is one of the most common complications and is a major cause of re-admission after intra-abdominal surgery. The initial management of patients with ASBO is nonoperative treatment such as nil per os and decompression using a nasogastric tube. However, the ideal management of ASBO remains controversial.

Methods: This study will be a prospective, single-center, double-blind randomized controlled trial. Ninety two participants diagnosed with ASBO will be randomly assigned to either the verum or the sham laser acupuncture (SLA) group in a 1:1 ratio. All participants will undergo laser acupuncture (LA) or SLA once a day on 6 acupoints (LI4, PC6, ST25, ST36, CV4 and CV12) for 6 consecutive days after enrollment. The primary outcome measure will be the success rate of conservative treatment for ASBO. Secondary outcomes will be time to oral intake and length of hospital stay. The serum levels of lipase, amylase, cortisol, motilin, ghrelin, and intestinal fatty acid binding protein (I-FABP) will also be measured before intervention, on day 4, and on the day of discharge, respectively. Data will be analyzed by Chi-Squared test or t test between 2 groups.

Objectives: The aim of this protocol is to investigate the clinical efficacy of LA on ASBO.

Trial registration: ClinicalTrials.gov Identifier: NCT04318821. Registered on 24 March 2020.

Conflict of interest statement

The authors have no conflicts of interests to disclose.

Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

Figures

Figure 1
Figure 1
The flowchart of the trial.
Figure 2
Figure 2
Acupoints used in the study: LI4, PC6, ST25, ST36, CV12, and CV4.

References

    1. Ten Broek RPG, Issa Y, van Santbrink EJP, et al. . Burden of adhesions in abdominal and pelvic surgery: systematic review and met-analysis. BMJ 2013;347:f5588–15588.
    1. Attard J-AP, MacLean AR. Adhesive small bowel obstruction: epidemiology, biology and prevention. Can J Surg 2007;50:291–300.
    1. Ten Broek RPG, Krielen P, Di Saverio S, et al. . Bologna guidelines for diagnosis and management of adhesive small bowel obstruction (ASBO): 2017 update of the evidence-based guidelines from the world society of emergency surgery ASBO working group. World J Emerg Surg 2018;13:1–3.
    1. Keenan JE, Turley RS, McCoy CC, et al. . Trials of nonoperative management exceeding 3 days are associated with increased morbidity in patients undergoing surgery for uncomplicated adhesive small bowel obstruction. J Trauma Acute Care Surg 2014;76:1367–72.
    1. Liu Y, May BH, Zhang AL, et al. . Acupuncture and related therapies for treatment of postoperative ileus in colorectal cancer: a systematic review and meta-analysis of randomized controlled trials. Evid Based Complement Alternat Med 2018;2018:3178472.1–18.
    1. Teixeira ML, Vasconcellos LS, Oliveira TG, et al. . Prevention of abdominal adhesions and healing skin after peritoniectomy using low level laser. Lasers Surg Med 2015;47:817–23.
    1. Camporesi EM. Side effects of hyperbaric oxygen therapy. Undersea Hyperbaric Med 2014;41:253–7.
    1. World Health Organization. WHO standard acupuncture point locations in the Western Pacific Region. 2008;35–225.
    1. Behman R, Nathens AB, Mason S, et al. . Association of surgical intervention for adhesive small-bowel obstruction with the risk of recurrence. JAMA Surg 2019;154:413–20.
    1. Wessels LE, Calvo RY, Dunne CE, et al. . Outcomes in adhesive small bowel obstruction from a large statewide database: what to expect after nonoperative management. J Trauma Acute Care Surg 2019;86:651–7.
    1. Catena F, Di Saverio S, Coccolini F, et al. . Adhesive small bowel adhesions obstruction: Evolutions in diagnosis,1; management and prevention. World J Gastrointest Surg 2016;8:222–31.
    1. Ernst E. Acupuncture--a critical analysis. J Intern Med 2006;259:125–37.
    1. Chon TY, Mallory MJ, Yang J, et al. . Laser acupuncture: a concise review. Med Acupunct 2019;31:164–8.
    1. Du MH, Luo HM, Tian YJ, et al. . Electroacupuncture ST36 prevents postoperative intra-abdominal adhesions formation. J Surg Res 2015;195:89–98.
    1. Zhang L, Wang H, Huang Z, et al. . Inhibiting effect of electroacupuncture at zusanli on early inflammatory factor levels formed by postoperative abdominal adhesions. Evid Based Complement Alternat Med 2014;2014:950326.1–5.
    1. Nereo Vettoretto GP, Matheos Romessis, Andrea Ferrari Bravo, et al. . Laparoscopy in afferent loop obstruction presenting as acute pancreatitis. J Soc Laparosc Robot Surg 2006;10:270–4.
    1. Fathima Z, Kamil Faiz SM, Mahak Saad, et al. . Prognostic value of serum lipase levels in patients with small bowel obstruction. Proc (Bayl Univ Med Cent) 2018;31:276–9.
    1. Rogier A, Quax LM, Jan W Koper, et al. . Glucocorticoid sensitivity in health and disease. Nat Rev Endocrinol 2013;9:670–86.
    1. Vincent L, Wester EFCvR. Clinical applications of cortisol measurements in hair. Eur J Endocrinol 2015;173:M1–10.
    1. Emma K, Adam MEQ, Royette Tavernier, et al. . Diurnal cortisol slopes and mental and physical health outcomes: a systematic review and meta-analysis. Psycho Neuro Endocrinol 2017;83:25–41.
    1. Kitazawa T, Kaiya H. Regulation of gastrointestinal motility by motilin and ghrelin in vertebrates. Front Endocrinol 2019;10:278.1–17.
    1. Takeshi K YHK, Kathryn Kiefer, Rommel Morales, et al. . Circulating intestinal fatty acid-binding protein (I-FABP) levels in acute decompensated heart failure. Clin Biochem 2017;50:491–5.
    1. Maika Voth TL, Borna R, Ingo M. Is I-FABP not only a marker for the detection abdominal injury but also of hemorrhagic shock in severely injured trauma patients? World J Emerg Surg 2019;14:49.1–9.

Source: PubMed

3
Suscribir