title: Acupuncture for recovery after surgery in patients undergoing colorectal cancer resection: a systematic review and meta-analysis.
abstract: OBJECTIVE
  To assess the efficacy/effectiveness and safety of acupuncture in patients recovering from colorectal cancer resection.
  
  
  METHODS
  We systematically searched four English language databases (Medline, Embase, CENTRAL (Cochrane Central Register of Controlled Trials), and AMED (Allied and Complementary Medicine Database)) and one Chinese database (CAJ, China Academic Journals). Randomised trials of acupuncture compared with usual/routine care, sham interventions or active comparators in patients undergoing colorectal cancer resection were eligible for inclusion. Postoperative symptoms and quality of life (QoL) were the primary outcomes for the review.
  
  
  RESULTS
  Of 1225 screened hits, seven randomised trials with 540 participants were included. High or uncertain risk of bias and significant heterogeneity were observed. All outcomes were measured before discharge, and no trial explicitly reported post-discharge outcomes. The response to acupuncture in terms of postoperative symptoms was inconsistent across trials. QoL was not measured in the included studies. For certain outcomes reflecting physiological recovery, favourable effects of acupuncture were observed compared with sham acupuncture, namely time to first flatus (n=207, three studies; mean difference (MD) -7.48 h, 95% CI -14.58 to -0.39 h, I(2)=0%) and time to first defaecation (n=149, two studies; MD -18.04 h, 95% CI -31.90 to -4.19 h, I(2)=0%). Two studies reported there were no acupuncture-related adverse events, whereas the remaining studies did not consider adverse events.
  
  
  CONCLUSIONS
  We found low-to moderate-quality evidence for the efficacy and safety of acupuncture for recovery after surgery in colorectal cancer patients. Future trials with adequate allocation concealment, blinding of outcome assessors, and measurement of post-discharge outcomes including QoL or functional recovery are warranted.
  
  
  BACKGROUND
  CRD42014015537.
authors.affiliation: School of Korean Medicine, Pusan National University, Yangsan, South Korea.
authors.forename: Kun Hyung
authors.initials: KH
authors.lastname: Kim
authors.affiliation: Department of Acupuncture & Moxibustion, Korean Medicine Hospital, Pusan National University, Yangsan, South Korea.
authors.forename: Dae Hun
authors.initials: DH
authors.lastname: Kim
authors.affiliation: Department of Anesthesia and Pain Medicine, Pusan National University Yangsan Hospital, Yangsan, South Korea.
authors.forename: Hee Young
authors.initials: HY
authors.lastname: Kim
authors.affiliation: Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, South Korea.
authors.forename: Gyung Mo
authors.initials: GM
authors.lastname: Son
mesh_terms: D015670:Acupuncture Therapy / Q000009:adverse effects; D015179:Colorectal Neoplasms / Q000601:surgery*; D006801:Humans; D011182:Postoperative Care
keywords: ACUPUNCTURE; COMPLEMENTARY MEDICINE; ONCOLOGY