Is nasogastric or nasojejunal decompression necessary after gastrectomy? A prospective randomized trial.
BACKGROUND
Nasogastric decompression has been routinely used in most major abdominal operations to prevent the consequences of postoperative ileus. The aim of the present study was to assess the necessity for routine prophylactic nasogastric or nasojejunal decompression after gastrectomy.


METHODS
A prospective randomized trial included 84 patients undergoing elective partial or total gastrectomy. The patients were randomized to a group with a postoperative nasogastric or nasojejunal tube (Tube Group, n = 43) or to a group without a tube (No-tube Group, n = 41). Gastrointestinal function, postoperative course, and complications were assessed.


RESULTS
No significant differences in postoperative mortality or morbidity, especially fistula or intra-abdominal sepsis, were observed between the groups. Passage of flatus (P < 0.01) and start of oral intake (P < 0.01) were significantly delayed in the Tube Group. Duration of postoperative perfusion (P = 0.02) and length of hospital stay (P = 0.03) were also significantly longer in the Tube Group. Rates of nausea and vomiting were similar in the two groups. Moderate to severe discomfort caused by the tube was observed in 72% of patients in the Tube Group. Insertion of a nasogastric or nasojejunal tube was necessary in 5 patients in the No-tube Group (12%).


CONCLUSIONS
Routine prophylactic postoperative nasogastric decompression is unnecessary after elective gastrectomy.
Carrère
Nicolas
N
Department of Gastrointestinal Surgery (Pr Pradère), Purpan University Hospital, CHU de Toulouse, Place du Dr Baylac, 31059 Toulouse Cedex, France, carrere.n@chu-toulouse.fr
Seulin
Patrick
P
Julio
Charles Henri
CH
Bloom
Eric
E
Gouzi
Jean-Luc
JL
Pradère
Bernard
B
D000368:Aged; D019299:Decompression, Surgical / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D005743:Gastrectomy; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D011184:Postoperative Period; D011446:Prospective Studies