Assessment of routine elimination of postoperative nasogastric decompression after Roux-en-Y gastric bypass.
BACKGROUND
Anastomotic disruption after surgical intervention is an infrequent complication, but may lead to severe morbidity and mortality when it occurs. Of the various gastric procedures, the Roux-en-Y gastric bypass (RYGB) has one of the highest risks for anastomotic leakage. Consequently, a nasogastric tube (NGT) is frequently placed when these operations are performed. Most studies examining the outcomes for patients without postoperative NGTs have been relatively small with groups of patients undergoing a variety of operations. Assessing the incidence of anastomotic leaks by routine elimination of postoperative NGTs requires a large number of patients. In this study, we assessed the safety and efficacy of routine elimination of NGTs in a large cohort of patients undergoing a single operation.


METHODS
We reviewed our experience with 1067 patients who underwent RYGB at the UCLA medical center. Fifty-six patients had NGTs routinely placed before the implementation of a standard protocol, which eliminated postoperative NGT decompression. The complication rate for the RYGB patient cohort with and without postoperative NGT was compared.


RESULTS
We found no difference in the complication rates between the 2 groups (Fisher exact test; P =.21).


CONCLUSIONS
Our findings suggest that routine placement of an NGT after RYGB is unnecessary.
Huerta
Sergio
S
VAMC Greater Los Angeles Health Care System, the UCLA Bariatric Surgery Program, and the UCLA Center for Human Nutrition, Los Angeles, CA 90095, USA.
Arteaga
James R
JR
Sawicki
Mark P
MP
Liu
Carson D
CD
Livingston
Edward H
EH
D000328:Adult; D000713:Anastomosis, Roux-en-Y / Q000009:adverse effects; D015331:Cohort Studies; D005260:Female; D015390:Gastric Bypass / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007441:Intubation, Gastrointestinal; D008297:Male; D012449:Safety