The usefulness of intraoperative needle decompression of the colon during radical gastrectomy--a prospective and randomized trial.
OBJECTIVE
Intraoperative colonic distension is associated with postoperative ileus, which contributes to delayed hospital discharge. A randomized and prospective study was conducted, to evaluate the usefulness of intraoperative needle decompression of the colon during radical gastrectomy for gastric cancer.


METHODS
Fifty patients that had received subtotal or total gastrectomy for gastric cancer were randomly assigned to either a non-decompression (n=27) or a decompression group (n=23). Prior to the main procedure, the transverse or right colon was pulled up, and a 19-gauge disposable needle connected to suction was introduced to the colon through the taenia site of anterior wall. Gas collected in the colon was aspirated out. The time to the first postoperative passage of flatus or feces was measured precisely to evaluate the restoration of bowel function. Additional measures of outcome were the operation time, the complication rate, and hospital stay.


RESULTS
Demographic details, pathologic features, operation time, complication rate and hospital stay were not different between the two groups. A collapsed colon was required for good surgical exposure and easy manipulation. No unexpected complication related to this procedure was found. The first flatus was 6.8 hours sooner in the decompression group than in the non-decompression, though this result was not statistically significant.


CONCLUSIONS
This technique is a simple and safe procedure for intraoperative colon decompression during radical gastrectomy.
Kim
Min-Chan
MC
Department of Surgery, Dong-A University College of Medicine, Busan, Korea.
Park
Sung-Yeol
SY
Jung
Ghap-Joong
GJ
Kim
Hyung-Ho
HH
Noh
Sung-Hoon
SH
D003106:Colon / Q000601:surgery*; D019299:Decompression, Surgical; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D007432:Intraoperative Period; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011446:Prospective Studies; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*