Abstract
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Background: Effectively managing Postoperative Gastrointestinal Dysfunction (POGD) in patients with Colorectal Cancer (CRC) is crucial for facilitating early recovery and improving quality of life. Given the growing evidence supporting the effectiveness of non-pharmacological interventions in reducing POGD, it is necessary to compare their relative effectiveness. This network meta-analysis aimed to compare the effects of different non-pharmacological interventions on POGD in patients with CRC.
Methods: A comprehensive search for eligible Randomized Controlled Trials (RCTs) was conducted across eight databases from inception to April 2025. The risk of bias was evaluated using the RoB 2.0 tool, and the overall certainty of evidence was assessed using the GRADE approach. A network meta analysis was performed using Stata 18.0 and R software to compare the effectiveness of different categories of interventions for POGD.
Results: A total of 34 RCTs on 16 non-pharmacological interventions were included in the final analysis. Compared with usual care, moxibustion combined with medicine hot compress was most effective in shortening the time to first flatus (MD: -20.64) and the time to first bowel sounds (MD: -15.72). Acupressure combined with moxibustion showed superior efficacy in shortening the time to first defecation (MD: -27.25). Electroacupuncture was most effective for shortening the time to first oral feeding (MD: -22.58), whereas auricular acupressure combined with acupressure was most effective for reducing the incidence of postoperative complications (OR: 0.30).
Conclusion: Our study suggests that moxibustion combined with medicine hot compress, and acupressure combined with moxibustion may be more effective than isolated approaches in promoting the recovery of gastrointestinal function in patients with CRC. Future high-quality research and direct comparisons are still required to confirm and strengthen these findings.
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