Evaluation of the Routine Use of the Nasogastric Tube in Digestive Operations by a Prospective Controlled Study

Savasi-Rocha, P. R.; Conceição, Sérgio Alexandre da; Ferreira, Jonathan; Diniz, Marco Túlio Costa; Campos, I. C.; Fernandes, V. A.; Garavini, D.; Castro, Lorena

doi:10.1097/00132586-199212000-00025

Cited by 11 publications

(19 citation statements)

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“…In accordance with the related studies nasogastric decompression in early post-operative period is effective in surgeries performed on esophagus 10 (e.g. esophagectomy and pull through procedures), stomach 11,12 (e.g.…”

Section: Discussionsupporting

confidence: 76%

Routine versus early nasogastric decompression in gastrointestinal surgeries: a randomized controlled trial

et al. 2015

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Background: Traditionally nasogastric decompression is carried out in post operatively in patients undergoing gastrointestinal surgery. The purpose of the study is to assess the benefits of nasogastric decompression in the early postoperative period as compared to routine nasogastric decompression in patients undergoing gastrointestinal surgeries. Objectives: To assess the benefits of nasogastric decompression in the early postoperative period as compared to routine nasogastric decompression in patients undergoing gastrointestinal surgeries, to assess the complications associated with nasogastric tube insertion, and to assess the effect of early nasogastric tube removal on the patients' postoperative morbidity and comfort level. Methods: This was a randomized control trial done in the Shree Sayajirao General Hospital, Vadodara. According to patient flow and previous study details the estimated sample size was 300 patients. Patient allotment was 150 patients in each group. Patients admitted on odd dates will be followed for routine nasogastric decompression, and patients admitted on even dates will be followed for early nasogastric decompression. Inclusion criteria for the study include laparotomies performed by any abdominal incisions on emergency as well as elective bases. Variables to be studied were patient comfort (according to patient's opinion), vomiting (episodes, type, amount, content, on which postoperative day), abdominal distension, appearance of normal bowel sounds, passage of flatus and/or stools (according to patient's history), incidence of aspiration pneumonia and total duration of the hospital stay with wound complications. Data will be processed and analyzed by chi square test and t-test. Results: In the study total 300 patients were included. No significant difference between both the groups in case of postoperative vomiting with p-value of 0.6028 (i.e. p > 0.05) and abdominal distension with p-value of 0.5183 (i.e. p > 0.05). Significant difference seen in the appearance of the bowel sound in post-operative period with p-value of 0.0002 (i.e. p < 0.05) and passage of flatus or stool with p-value of <0.0001. In case of early decompression group mean postoperative day for the suture removal was 11.9 days and for routine decompression group it was 12.3 days, the difference was statistically significant with p-value of 0.0006 (i.e. p < 0.05). The mean for the total hospital stay for early decompressed group was 10.04 days and for routine decompression group it was 10.47 days which was highly statically significant with p-value of 0.0001 (i.e. p < 0.05). Post-operative wound complication which was statically significance with p-value of 0.0394 (i.e. p < 0.05) and respiratory complications was also significant with pvalue of 0.0367 (i.e. p < 0.05). In case of early decompression post-operative nausea, vomiting and abdominal distention were higher but not significant statistically. Conclusions: Early removal of Ryle's tube leads to less incidence of respiratory complications and wound compli...

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Section: Discussionsupporting

confidence: 76%

Routine versus early nasogastric decompression in gastrointestinal surgeries: a randomized controlled trial

et al. 2015

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“…Routine NG decompression following gastrointestinal tract surgery can often be safely eliminated, [27][28][29][30][31][32] but the practice of gastric decompression remains common. In our patients, only 3 (9%) of the 34 patients had documentation that the NG intubation was for symptoms 1 to 2 days postoperatively.…”

Section: Commentmentioning

confidence: 99%

Multivariate Analysis of Factors Associated With Postoperative Pulmonary Complications Following General Elective Surgery

Mitchell

Smoger²,

Pfeifer³

et al. 1998

Arch Surg

157

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To develop a predictive model identifying perioperative conditions associated with postoperative pulmonary complications (PPCs).Design: A prospective survey of patients whose preoperative history and physical examination, spirometric, PaO 2 and PaCO 2 analysis, and operative results were recorded. These patients underwent postoperative cardiopulmonary examinations until they were discharged from the hospital; their medical records were also reviewed until they were discharged from the hospital.

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“…Many clinical studies have suggested that this practice does not provide any benefit but could increase patient discomfort and respiratory complications [1][2][3]. Furthermore, three recent meta-analyses concluded that nasogastric or nasojejunal decompression does not promote the recovery of gastrointestinal function or reduce the incidence of postoperative complications after gastrectomy for gastric cancer and after abdominal surgery [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Naso-gastric or naso-jejunal decompression after partial distal gastrectomy for gastric cancer. Final results of a multicenter prospective randomized trial

et al. 2013

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Background Only a few, small, monocentric randomized controlled trials (RCTs) have compared routine vs. no placement of a nasogastric or nasojejunal tube decompression (NG/NJT) in patients undergoing partial distal gastrectomy (PDG) for gastric cancer. However, to our knowledge, no multicenter prospective RCT has analyzed the role of decompression after both the Billroth II (BII) procedure and Roux-en-Y (RY) gastrojejunostomy.The aim of this study was to determine whether NG/NJT prevents the consequences of postoperative ileus after PDG for gastric cancer after both BII reconstruction and RY. Methods Two hundred seventy patients undergoing PDG for gastric cancer were randomly assigned NG/NJT placement (NG/NJT group) or not (no-NG/NJT group) with either Billroth II gastrojejunostomy or Roux-en-Y gastrojejunostomy. The patients were monitored for postoperative complications, mortality, and postoperative course. Results By January 2010 to June 2012, among 270 patients undergoing PDG for gastric cancer, 134 were randomly assigned to NG/NJT placement (NG/NJT group) and 136 to no decompression (no-NG/NJT group). Time to passage of flatus was significantly shorter in the NG/NJT group than in the no-NG/NJT group, but only after RY reconstruction (3.3 ± 1.5 vs. 4.3 ± 1.6 days, P \ 0.001, respectively).

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Evaluation of the Routine Use of the Nasogastric Tube in Digestive Operations by a Prospective Controlled Study

Cited by 11 publications

References 0 publications

Routine versus early nasogastric decompression in gastrointestinal surgeries: a randomized controlled trial

Routine versus early nasogastric decompression in gastrointestinal surgeries: a randomized controlled trial

Multivariate Analysis of Factors Associated With Postoperative Pulmonary Complications Following General Elective Surgery

Naso-gastric or naso-jejunal decompression after partial distal gastrectomy for gastric cancer. Final results of a multicenter prospective randomized trial

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