Electroacupuncture improves psychosocial outcomes in rectal cancer patients with bowel dysfunction

Abstract

BACKGROUND

Low anterior resection syndrome (LARS) is a prevalent and debilitating complication following sphincter-preserving surgery for rectal cancer. Evidence-based interventions for the concurrent psychological burden are limited. Electroacupuncture has been proposed as a potential adjunctive therapy, but its psychological benefits remain inadequately studied.

AIM

To investigate the therapeutic effect of electroacupuncture on emotional recovery and gastrointestinal function in patients with moderate to severe LARS, and to explore its potential advantages in psychologically vulnerable subgroups.

METHODS

We conducted a retrospective, controlled study involving 100 patients with moderate to severe LARS (LARS score ≥ 21) treated at two tertiary hospitals in China between January 2022 and December 2024. Patients received either standard postoperative care alone (n = 50) or in combination with a standardized 4-week electroacupuncture protocol (n = 50). Psychological and functional outcomes were assessed using validated instruments including Hospital Anxiety and Depression Scale (HADS), Body Image Scale (BIS), General Self-Efficacy Scale, Perceived Social Support Scale (PSSS), LARS score, and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 at four time points. The primary endpoint was emotional remission, defined as a ≥ 3-point reduction in HADS-Anxiety subscale (HADS-A). Analyses included repeated-measures comparisons, Kaplan-Meier survival curves, Cox regression models, and subgroup-interaction testing.

RESULTS

At baseline, demographic, surgical, and psychosocial characteristics were comparable among groups. By week 4, patients receiving electroacupuncture demonstrated significantly greater reductions in anxiety (HADS-A: 4.8 ± 2.6 vs 7.3 ± 3.0; P < 0.001), depression, and body-image disturbance (BIS: 8.7 ± 3.6 vs 11.9 ± 4.2; P < 0.001), alongside enhanced coping capacity (Brief Coping Orientation to Problems Experienced), perceived social support (PSSS), and bowel function (LARS score). Emotional remission - defined as a ≥ 3-point HADS-A reduction - was achieved more rapidly in the electroacupuncture group, as confirmed by Kaplan-Meier analysis (log-rank P < 0.001; odds ratio = 4.7). Multivariate Cox regression identified higher baseline LARS and BIS scores as independent predictors of delayed emotional recovery. Subgroup analyses revealed significantly amplified treatment benefits in patients with high baseline anxiety (HADS-A ≥ 8), elevated body-image disturbance (BIS ≥ 12), or low perceived social support (PSSS < 60), with consistent interaction effects (P for interaction < 0.05 across subgroups).

CONCLUSION

Electroacupuncture may accelerate emotional recovery and improve functional and psychosocial outcomes in patients with LARS. Its integration into postoperative care may offer particular benefits for psychologically vulnerable subgroups.

Keywords: Low anterior resection syndrome; Electroacupuncture; Psychosocial outcomes; Social support; Coping mechanisms; Rectal cancer survivors; Psychological intervention

Core Tip: Low anterior resection syndrome impairs both bowel function and emotional health after rectal cancer surgery. This controlled study shows that electroacupuncture significantly improves anxiety, depression, body image, and bowel symptoms. Emotional remission occurred faster in the electroacupuncture group, especially among patients with high psychological burden. The findings support electroacupuncture as a safe, multidimensional approach for low anterior resection syndrome rehabilitation and highlight the value of targeted psychosocial interventions in colorectal cancer survivorship care.