The role of nasogastric tube in decompression after elective colon and rectum surgery: a meta-analysis.
OBJECTIVE
Nasogastric tubes (NGT) have been routinely used after abdominal procedures, largely due to the accepted tradition, especially in China. However, studies recently questioned the role of routine NGT intubation by stating that it was overused and many complications occurred from its use.


METHODS
Herein, we performed a systematic review and a meta-analysis evaluating the role of NGT in decompression after elective colon and rectum surgery.


RESULTS
Four fixed-effect models and three randomized-effect models were used for statistics pooling of the relative risks (RR) for the different outcomes. A total of seven articles (1,416 patients) fulfilled the inclusion criteria. Patients in NGT group had less vomiting (p < 0.00001; RR = 2.85; 95% CI [2.12, 3.83]), less nasogastric tube replacement (p < 0.00001; RR = 3.90; 95% CI [2.34, 6.52]), but more pharyngolaryngitis (p < 0.00001 RR = 0.14; 95% CI [0.08, 0.26]) and more respiratory infection (p = 0.004; RR = 0.37; 95% CI [0.19, 0.74]). No statistically significant differences were noted in nausea, wound infection or intestinal obstruction.


CONCLUSIONS
In conclusion, routine NGT decompression did no good to the time to return gastrointestinal function, but increased the morbidity of pharyngolaryngitis and respiratory infection significantly. Routine NGT was not recommended for patients after elective colon and rectum surgery.
Department of General Surgery, Shanghai Changzheng Hospital, affiliated to the Second Military Medical University, Shanghai, China.
Wensheng
W
Rao
Xue
X
Zhang
Jian
J
Zhang
Ronglin
R
Yan
Zhiqian
Z
Hu
Qiang
Q
Wang
D002986:Clinical Trials as Topic; D003106:Colon / Q000601:surgery*; D019299:Decompression, Surgical / Q000009:adverse effects / Q000379:methods*; D013505:Digestive System Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D017558:Elective Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000009:adverse effects / Q000295:instrumentation*; D011183:Postoperative Complications / Q000209:etiology; D017594:Publication Bias; D012007:Rectum / Q000601:surgery*; D016896:Treatment Outcome