title: The necessity of indwelling gastrointestinal decompression after gastrectomy: a meta-analysis.
abstract: BACKGROUND
  This meta-analysis was designed to evaluate the necessity of indwelling gastrointestinal decompression after gastrectomy.
  
  
  METHODS
  Medline, Embase, and the Cochrane Library were searched. We identified randomized controlled trials that compared individuals with or without gastrointestinal decompression after gastrectomy, and a meta-analysis was performed on data regarding the recovery time of gastrointestinal function, length of hospital stay, complications, and mortality using fixed effect and random effect models.
  
  
  RESULTS
  Eight randomized controlled trials that had enrolled 975 patients were included in the present study. The difference in the interval to oral intake (weighted mean difference 0.56, 95% confidence interval [CI] 0.16-0.96, P = 0.006) between the decompression group and nondecompression group was significant, but no significant differences were found in the interval to flatus (weighted mean difference 0.24, 95% CI -0.13 to 0.61, P = 0.20) or length of hospital stay (weighted mean difference 1.04, 95% CI -0.05 to 2.14, P = 0.06). Additionally, no significant differences were found in complications, including nausea or vomiting (odds ratio [OR] 1.23, 95% CI 0.57-2.65, P = 0.59), fever (OR 1.55, 95% CI 0.96-2.51, P = 0.07), pulmonary complications (OR 1.41, 95% CI 0.82-2.43, P = 0.22), anastomotic leakage (OR 1.15, 95% CI 0.55-2.40, P = 0.70), paralytic ileus or small bowel obstruction (OR 1.80, 95% CI 0.57-5.70, P = 0.32), intra-abdominal abscess (OR 1.08, 95% CI 0.50-2.34, P = 0.84), wound infection (OR 1.29, 95% CI 0.56-2.96, P = 0.55), or wound dehiscence (OR 1.47, 95% CI 0.43-4.95, P = 0.54) between the two groups. A sensitivity analysis of the pooled data from high-quality studies and studies with >20 cases per group showed that the length of hospital stay was prolonged significantly in the decompression group compared with the nondecompression group.
  
  
  CONCLUSIONS
  Routine gastrointestinal decompression after gastrectomy does not promote the recovery of gastrointestinal function or reduce the incidence of postoperative complications. In our series, decompression was correlated with a prolonged interval to oral intake, a longer duration of hospitalization, and increased patient discomfort.
authors.affiliation: Department of Gastrointestinal Surgery, Guizhou Provincial People's Hospital, Guiyang, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Ding
authors.forename: Guoqing
authors.initials: G
authors.lastname: Liao
authors.forename: Yu
authors.initials: Y
authors.lastname: Xia
authors.forename: Zhong-Min
authors.initials: ZM
authors.lastname: Zhang
authors.forename: Yang
authors.initials: Y
authors.lastname: Pan
authors.forename: Sheng
authors.initials: S
authors.lastname: Liu
authors.forename: Zhong-Shu
authors.initials: ZS
authors.lastname: Yan
mesh_terms: D019299:Decompression, Surgical / Q000639:trends*; D004435:Eating; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D005767:Gastrointestinal Diseases / Q000601:surgery*; D041981:Gastrointestinal Tract / Q000502:physiology / Q000601:surgery*; D006801:Humans; D015994:Incidence; D007902:Length of Stay; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology