Routine nasogastric tubes are not required following cystectomy with urinary diversion: a comparative analysis of 430 patients.
OBJECTIVE
Postoperative nasogastric tube (NGT) use has been shown to increase postoperative morbidity in patients undergoing nonurological abdominal surgery. We examine the omission of NGTs as a method of decreasing postoperative gastrointestinal complications and hospital stay in patients undergoing cystectomy with urinary diversion.


METHODS
Between January 1983 and December 2001, 430 patients underwent cystectomy with urinary diversion at our institution. We retrospectively compared patients who received postoperative NGTs with those who did not with regard to gastrointestinal recovery time, gastrointestinal complications and hospital stay.


RESULTS
After correcting for confounding factors using ANCOVA the time to first bowel sounds, time to first flatus and the duration of hospitalization were shorter in patients not receiving NGTs (p = 0.006, 0.001 and 0.032, respectively). Omitting NGTs did not increase the risk of ileus, bowel obstruction, wound dehiscence, anastomotic leakage or aspiration pneumonia and it did not result in more frequent postoperative NGT placement.


CONCLUSIONS
The results of the current study suggest that gastric decompression with NGTs following cystectomy with urinary diversion may prolong gastrointestinal recovery, which may be a factor leading to increased duration of hospitalization. We propose that postoperative NGTs should not be used routinely in the management of cystectomy cases.
Inman
Brant A
BA
Department of Surgery, Laval University, Quebec City, Quebec, Canada G1R 2J6.
Harel
François
F
Tiguert
Rabi
R
Lacombe
Louis
L
Fradet
Yves
Y
D000368:Aged; D015653:Cystectomy; D005260:Female; D005769:Gastrointestinal Motility / Q000502:physiology*; D006801:Humans; D045823:Ileus / Q000453:epidemiology* / Q000503:physiopathology / Q000517:prevention & control; D007441:Intubation, Gastrointestinal / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008432:Mathematical Computing; D008875:Middle Aged; D011015:Pneumonia, Aspiration / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control; D011182:Postoperative Care; D011183:Postoperative Complications / Q000453:epidemiology* / Q000503:physiopathology / Q000517:prevention & control; D012189:Retrospective Studies; D012307:Risk Factors; D013529:Surgical Wound Dehiscence / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control; D014547:Urinary Diversion