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.).