title: Randomized Clinical Trial Comparing Efficacy of Simo Decoction and Acupuncture or Chewing Gum Alone on Postoperative Ileus in Patients With Hepatocellular Carcinoma After Hepatectomy.
abstract: To compare the efficacy of simo decoction (SMD) combined with acupuncture at the tsusanli acupoint or chewing gum alone for treating postoperative ileus in patients with hepatocellular carcinoma (HCC) after hepatectomy.In postoperative ileus, a frequent complication following hepatectomy, bowel function recovery is delayed, which increases length of hospital stay. Studies suggest that chewing gum may reduce postoperative ileus; SMD and acupuncture at the tsusanli acupoint have long been used in China to promote bowel movement.Patients with primary HCC undergoing hepatectomy between January 2015 and August 2015 were randomized to receive SMD and acupuncture (n = 55) or chewing gum (n = 53) or no intervention (n = 54) starting on postoperative day 1 and continuing for 6 consecutive days or until flatus. Primary endpoints were occurrence of postoperative ileus and length of hospital stay; secondary endpoints were surgical complications.Groups treated with SMD and acupuncture or with chewing gum experienced significantly shorter time to first peristalsis, flatus, and defecation than the no-intervention group (all P < 0.05). Hospital stay was significantly shorter in the combined SMD and acupuncture group (mean 14.0 d, SD 4.9) than in the no-intervention group (mean 16.5 d, SD 6.8; P = 0.014), while length of stay was similar between the chewing gum group (mean 14.7, SD 6.2) and the no-intervention group (P = 0.147). Incidence of grades I and II complications was slightly lower in both intervention groups than in the no-intervention group.The combination of SMD and acupuncture may reduce incidence of postoperative ileus and shorten hospital stay in HCC patients after hepatectomy. Chewing gum may also reduce incidence of ileus but does not appear to affect hospital stay. (Clinicaltrials.gov registration number: NCT02438436.).
authors.affiliation: From the Hepatobiliary Surgery Department, Affiliated Tumor Hospital of Guangxi Medical University (XMY, XSM, LM, JHZ, HGQ, ZL, BDX, FXW, YHP, JT, XHZ, JC, LQL); and Guangxi Liver Cancer Diagnosis and Treatment Engineering and Technology Research Center, Nanning, PR China (XMY, LM, JHZ, BDX, FXW, YHP, JT, XHZ, JC, LQL).
authors.forename: Xue-Mei
authors.initials: XM
authors.lastname: You
authors.forename: Xin-Shao
authors.initials: XS
authors.lastname: Mo
authors.forename: Liang
authors.initials: L
authors.lastname: Ma
authors.forename: Jian-Hong
authors.initials: JH
authors.lastname: Zhong
authors.forename: Hong-Gui
authors.initials: HG
authors.lastname: Qin
authors.forename: Zhan
authors.initials: Z
authors.lastname: Lu
authors.forename: Bang-De
authors.initials: BD
authors.lastname: Xiang
authors.forename: Fei-Xiang
authors.initials: FX
authors.lastname: Wu
authors.forename: Xin-Hua
authors.initials: XH
authors.lastname: Zhao
authors.forename: Juan
authors.initials: J
authors.lastname: Tang
authors.forename: Yong-Hui
authors.initials: YH
authors.lastname: Pang
authors.forename: Jie
authors.initials: J
authors.lastname: Chen
authors.forename: Le-Qun
authors.initials: LQ
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015670:Acupuncture Therapy; D002638:Chewing Gum; D002681:China / Q000453:epidemiology; D004365:Drugs, Chinese Herbal / Q000627:therapeutic use; D006498:Hepatectomy / Q000009:adverse effects; D045823:Ileus / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D015994:Incidence; D007902:Length of Stay; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control
chemical_list: D002638:Chewing Gum; D004365:Drugs, Chinese Herbal; C542832:simo