title: Nasogastric tube use in children after abdominal surgery- how long should it be kept in Situ?
abstract: BACKGROUND
  Traditionally, the use of a nasogastric tube (NGT) after a laparotomy is said to prevent vomiting, aspiration, abdominal distension and paralytic ileus, which are likely to complicate the postoperative course.
  
  
  OBJECTIVE
  To determine if discontinuation of NGT within 24 hours of abdominal surgical procedures in children has any effect on postoperative recovery.
  
  
  METHODS
  We prospectively studied children who needed NGT passed for abdominal surgical procedures. NGTs were removed within 24 hours in all but 46 children who had the tube in situ for 3 to 5 days. Time to first and full oral feeds, length of hospital stay and complications were compared between the groups.
  
  
  RESULTS
  Children who had their NGTs removed within 24 hours (N = 120, Group 1) were compared with those who had NGT in place for 3 to 5 days (N = 46, Group 2). The mean time to first oral sips was 1.02 ± 0.13 days for Group 1 and 3.09 ± 0.29 days for Group 2 (p = 0.001). The mean time to full feeding was 2.22 ± 0.54 days for Group 1 and 4.54 ± 0.55 days for Group 2 (p = 0.001). Mean length of hospital stay (LOHS) was 8.32 ± 5.49 days for Group 1 and 12.78 ± 8.79 days for Group 2 (p = 0.001). Mean LOHS was 9.55 ± 6.85 days for both groups combined. Ten complications associated with the removal of the NGT occurred in both groups- 6 in Group 1 and 4 in Group 2 (p = 0.37). These were mainly vomiting and abdominal distension.
  
  
  CONCLUSIONS
  Our findings suggest that routine use of NGTs for decompression after laparotomy may be safely dispensed with after the child has recovered from anaesthesia.
authors.affiliation: Department of Surgery, Komfo Anokye Teaching Hospital, P. O. Box 1934, Kumasi, Ghana.
authors.forename: F A
authors.initials: FA
authors.lastname: Abantanga
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D002985:Clinical Protocols; D019299:Decompression, Surgical / Q000009:adverse effects / Q000379:methods; D004750:Enteral Nutrition / Q000009:adverse effects / Q000379:methods; D005260:Female; D005869:Ghana; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D007813:Laparotomy / Q000009:adverse effects / Q000379:methods; D007902:Length of Stay; D008297:Male; D011182:Postoperative Care / Q000009:adverse effects / Q000379:methods; D011183:Postoperative Complications / Q000145:classification / Q000517:prevention & control*; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014839:Vomiting / Q000209:etiology