Published online Oct 27, 2026. doi: 10.4240/wjgs.121942
Revised: May 26, 2026
Accepted: September 4, 2026
Published online: October 27, 2026
Processing time: 177 Days and 22.9 Hours
Postoperative ileus (POI) and delayed bowel function recovery remain common challenges after abdominal surgery, even in the context of enhanced recovery after surgery protocols. Electroacupuncture has been increasingly investigated as a low-drug-burden adjunctive intervention for promoting gastrointestinal motility and modulating postoperative neuroimmune responses. However, existing cli
To systematically evaluate the efficacy and safety of electroacupuncture as an adjunctive strategy for postoperative bowel function recovery after abdominal surgery, with particular attention to POI-related outcomes, clinical recovery indicators, adverse events, and the certainty of current evidence.
PubMed, EMBASE, Web of Science, the Cochrane Library, CNKI, Wanfang Data, VIP, and SinoMed/CBM were searched electronically for clinical studies on electroacupuncture for POI or other closely related non-mechanical postoperative bowel motility recovery disorders after abdominal surgery from January 1, 2006 to March 1, 2026. Two reviewers independently performed literature screening, data extraction, and risk-of-bias assessment. Meta-analysis was conducted using RevMan 5.4. Continuous outcomes were expressed as mean difference (MD) with 95% confidence intervals (95%CIs), and dichotomous outcomes as odds ratio (OR) with 95%CIs.
A total of 9 studies were included. Meta-analysis showed that electroacupuncture significantly shortened time to first flatus (MD = -10.91 hours, 95%CI: -15.07 to -6.74, P < 0.00001) and time to first defecation (MD = -19.80 hours, 95%CI: -28.60 to -11.01, P < 0.0001) in patients after abdominal surgery, and also reduced postoperative length of stay (MD = -0.93 days, 95%CI: -1.67 to -0.18, P = 0.01). In addition, electroacupuncture reduced the risk of prolonged/persistent POI (OR = 0.45, 95%CI: 0.33-0.60, P < 0.00001) and appeared to facilitate earlier ambulation (MD = -9.37 hours, 95%CI: -18.34 to -0.40, P = 0.04). Some studies reported mild adverse events, and no definite serious adverse events were described; however, safety reporting remained generally insufficient.
The present empirical data suggest that electroacupuncture might facilitate the recovery of bowel function after abdominal operations, mainly by decreasing the time to the first flatus and the first bowel movement, reducing the occurrence of prolonged POI, and possibly shortening the hospital stay and allowing an earlier start of physical exercise. Considering the differences among the various studies regarding the type of operation, treatment methods and the evaluation of therapeutic effects, as well as the lack of information about the safety aspects, these findings should be interpreted with caution. Further research, including high-quality, multi-centre and uniform investigations, is necessary to confirm these results.
Core Tip: This systematic review and meta-analysis suggest that electroacupuncture can significantly accelerate postoperative bowel recovery after abdominal surgery—shortening time to first flatus and defecation, reducing hospital stay, and lowering the risk of prolonged postoperative ileus—without serious adverse events reported. However, due to study heterogeneity and limited safety data, further high-quality research is warranted.