Nasogastric decompression after total gastrectomy.
OBJECTIVE
Although it is clearly known that there is no need of routine nasogastric decompression after some abdominal operations, we still do not know whether it is necessary for esophageal anastomosis. Traditionally, nasogastric decompression is mandatory after total gastrectomy complemented with esophagojejunostomy.


METHODS
Consecutive 66 patients with gastric cancer who underwent total gastrectomy and esophagojejunostomy were prospectively evaluated. Patients were divided into two groups, those with nasogastric decompression and those without decompression.


RESULTS
Postoperative complications were similar among the groups. Vomiting, distention, belching, hiccupping, dysphagia complaints were similar among the groups, but sore throat (100% vs. 22%, p<0.001), nausea (32% vs. 13%, p=0.054), fever (35% vs. 16%, p=0.068) and pulmonary complications (26% vs. 9%. p=0.072) were much more in the nasogastric decompression than the no-tube group. Starting oral feeding and postoperative hospital stay were similar in both groups.


CONCLUSIONS
Omission of nasogastric decompression after elective total gastrectomy complemented with esophagojejunostomy did not increase postoperative complications, on the contrary it decreased postoperative fever and pulmonary problems, and improved patient comfort by decreasing sore throat and nausea. Therefore, we do not recommend the routine use of nasogastric tubes after total gastrectomy complemented with esophagojejunostomy.
Akbaba
Soner
S
Department of Gastrointestinal Surgery, Turkey Yuksek Ihtisas Hospital, Ankara, Turkey.
Kayaalp
Cuneyt
C
Savkilioglu
Metin
M
D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D016022:Case-Control Studies; D003664:Decompression; D004947:Esophagus / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000379:methods*; D007583:Jejunum / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011178:Postgastrectomy Syndromes / Q000517:prevention & control*; D011336:Probability; D011446:Prospective Studies; D018570:Risk Assessment; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome