The role of tibial nerve stimulation for enhanced postoperative recovery after colorectal surgery: a double-blind, paral
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ORIGINAL ARTICLE
The role of tibial nerve stimulation for enhanced postoperative recovery after colorectal surgery: a double‑blind, parallel‑group, randomized controlled trial J. Martellucci1 · A. Sturiale1 · G. Alemanno1 · I. Bartolini2 · B. Pesi2 · F. Perna2 · A. Coratti2 · P. Prosperi1 · A. Valeri1 Received: 18 April 2020 / Accepted: 9 September 2020 © Springer Nature Switzerland AG 2020
Abstract Background Postoperative ileus (POI) is the most common cause of prolonged hospital stay following abdominal surgery, despite an optimized enhanced recovery after surgery (ERAS) program. The aim of the study was to evaluate the role of postoperative transcutaneous electrical tibial nerve stimulation (TTNS) in the recovery of bowel function and in shortening hospital stay after colonic resection. Methods Patients having elective laparoscopic colonic surgery within an ERAS program at our institution between June 2016 and June 2019 were enrolled and randomly assigned to a treatment protocol with TTNS or sham electrical stimulation. The primary endpoint was the time of recovery of gastrointestinal motility, measured as the first passage of stool. Secondary endpoints included: first passage of flatus, length of hospital stay, and complication rate related to the use of TTNS. Results One hundred and seventy patients who had right hemicolectomy (median age 71 years (range 43–89 years); 47.5% women) and 170 patients who had left colectomy (median age 67 years range (37–92 years); 41.5% women) were enrolled. The only factor significantly affected by TTNS was time to first passage of flatus after right hemicolectomy (reduced from 46 to 33 h, p = 0.04). However, if only patients with low compliance to early oral nutrition (63 of 340; 18.5%) were considered, a statistically significant difference in time until first flatus (p
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