Electrical acupoint stimulation for gastrointestinal recovery after gastrectomy for gastric cancer: a systematic review and meta-analysis.

Delayed gastrointestinal recovery remains a challenge after gastrectomy for gastric cancer, with residual variability even within enhanced recovery after surgery (ERAS) pathways. This residual variability has prompted interest in adjunctive approaches such as electrical acupoint stimulation (EAS), but gastrectomy-specific anatomical and neural features may limit extrapolation from broader abdominal-surgery populations. We therefore synthesized randomized evidence on EAS for postoperative gastrointestinal recovery and examined variation across study-level characteristics. We searched PubMed, Embase, Scopus, CENTRAL, China National Knowledge Infrastructure, Wanfang Data, SinoMed, and four registries from inception to a 1 August 2026 cutoff. We included randomized trials in patients undergoing gastrectomy for gastric cancer when EAS was separable from other traditional or acupoint-based co-interventions. Outcomes were time to first flatus (primary), first defecation, first liquid intake, and length of hospital stay. Safety was summarized descriptively. Risk of bias was assessed with the Cochrane Risk of Bias 2 tool and certainty with GRADE; exploratory subgroup differences were examined using interaction tests. Fifteen trials were eligible; 13 contributed to the primary pairwise comparison (1,357 participants) and two to narrative synthesis only. EAS was associated with shorter times to first flatus [13 trials; mean difference (MD), -9.61 h; 95% CI, -12.81 to -6.42;