Is nasogastric decompression useful in prevention of leaks after laparoscopic sleeve gastrectomy? A randomized trial.
BACKGROUND
Although its excellent results, laparoscopic sleeve gastrectomy (LSG) presents major complications ranging from 0% to 29%. Among them, the staple line leak presents an incidence varying from 0% to 7%. Many trials debated about different solutions in order to reduce leaks' incidence. No author has investigated the role of gastric decompression in the prevention of this complication. Aim of our work is to evaluate if this procedure can play a role in avoiding the occurrence of staple line leaks after LSG.


METHODS
Between January 2008 and November 2012, 145 patients were prospectively and randomly included in the study. Seventy patients composed the group A, whose operations were completed with placement of nasogastric tube; the other 75 patients were included in the group B, in which no nasogastric tube was placed.


RESULTS
No statistical differences were observed between group A and group B regarding gender distribution, age, weight, and BMI. No intraoperative complications and no conversion occurred in both groups. Intraoperative blood loss (50.1 ± 42.3 vs. 52.5 ± 37.6 ml, respectively) and operative time (65.4 ± 25.5 vs. 62.6 ± 27.8 min, respectively) were comparable between the two groups (p: NS). One staple line leak (1.4%) occurred on 6th postoperative day in group A patients. No leak was observed in group B patients. Postoperative hospital stay was significantly longer in group A vs. group B patients (7.6 ± 3.4 vs. 6.2 ± 3.1 days, respectively, p: 0.04).


CONCLUSIONS
Routine placement of nasogastric tube in patients operated of LSG seems not useful in reducing leaks' incidence.
Digestive Surgery Unit, Second University of Naples , via Pansini 5, Naples , Italy .
Gianluca
G
Rossetti
Landino
L
Fei
Ludovico
L
Docimo
Gianmattia
G
Del Genio
Fausta
F
Micanti
Annamaria
A
Belfiore
Luigi
L
Brusciano
Francesco
F
Moccia
Marco
M
Cimmino
Teresa
T
Marra
D000328:Adult; D050110:Bariatric Surgery; D005260:Female; D005743:Gastrectomy; D006801:Humans; D007441:Intubation, Gastrointestinal; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies; D055815:Young Adult
Bariatric surgery; laparoscopy; nasogastric tube; sleeve gastrectomy; staple line leak