Does the avoidance of nasogastric decompression following elective abdominal colorectal surgery affect the incidence of incisional hernia? Results of a prospective, randomized trial.
OBJECTIVE
In a previous, prospective, randomized study of the use of nasogastric tubes in patients undergoing elective abdominal colorectal surgery, we found that patients who did not have nasogastric (NG) decompression postoperatively had a significantly higher rate of abdominal distention, nausea, and vomiting. Patients from that study have now been followed for a median duration of 5.3 years to evaluate whether this elevation in perioperative intra-abdominal pressure would subsequently lead to an increased incidence of incisional hernia.


RESULTS
Of the 251 patients who received NG decompression, 8 (3.2 percent) developed incisional hernias compared with 15 (6.6 percent) of 229 patients who were not decompressed (P = 0.085).


CONCLUSIONS
The increase in postoperative abdominal distention and vomiting that occurs in patients who do not receive NG decompression does not lead to a significantly increased incidence of incisional hernia. Furthermore, we continue to support avoidance of routine prophylactic postoperative nasogastric decompression in uncomplicated, elective abdominal colorectal surgery.
Otchy
D P
DP
Department of Colon and Rectal Surgery, Mayo Clinic, Rochester, Minnesota 55905, USA.
Wolff
B G
BG
van Heerden
J A
JA
Ilstrup
D M
DM
Weaver
A L
AL
Winter
L D
LD
D003106:Colon / Q000601:surgery*; D017558:Elective Surgical Procedures; D005500:Follow-Up Studies; D006555:Hernia, Ventral / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D007441:Intubation, Gastrointestinal; D008150:Lower Body Negative Pressure; D011182:Postoperative Care; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies; D012007:Rectum / Q000601:surgery*