Unnecessary gastric decompression in distal elective bowel anastomoses in children: a randomized study.
BACKGROUND
The goal of this study was to investigate the role of nasogastric drainage in preventing postoperative complications in children with distal elective bowel anastomosis. Nasogastric drainage has been used as a routine measure after gastrointestinal surgery in children and adults to hasten bowel function, prevent postoperative complications, and shorten hospital stay. However, there has been no study that shows in a scientific manner the benefit of nasogastric drainage in children.


METHODS
We performed a clinical, controlled, randomized trial comprising 60 children who underwent distal elective bowel anastomoses and compared postoperative complications between a group with nasogastric tube in place (n = 29) and one without it (n = 31).


RESULTS
Demographic data and diagnoses were comparable in both groups (P = NS). No anastomotic leaks or enterocutaneous fistulae were found in any patient. There were no significant differences between the two groups with respect to abdominal distension, infection, or hospital stay. Only one patient in the experimental group required placement of the nasogastric tube due to persistent abdominal distension (3.2%).


CONCLUSIONS
The routine use of nasogastric drainage after distal elective intestinal surgery in children can be eliminated. Its use should depend on the individual patient's situation.
Pediatric Surgery, Hospital Infantil de Mexico Federico Gomez, Dr. Márquez No. 162, Col. Doctores, Delegación Cuauhtemoc, Mexico, DF, CP 06720, Mexico. robdape@rocketmail.com
Roberto
R
Davila-Perez
Eduardo
E
Bracho-Blanchet
Jose Manuel
JM
Tovilla-Mercado
Jose Alejandro
JA
Hernandez-Plata
Alfonso
A
Reyes-Lopez
Jaime
J
Nieto-Zermeño
D000714:Anastomosis, Surgical / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007422:Intestines / Q000601:surgery*; D007441:Intubation, Gastrointestinal; D008297:Male; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control