The value of gastrostomy in the surgery of aortic aneurysms

Morris, Tom; Bouhoutsos, John; Martin, Peter

doi:10.1002/bjs.1800610816

Cited by 10 publications

(4 citation statements)

References 6 publications

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“…Serious traumatic complications of NTs (e.g., perforation of the esophagus) have been occasionally reported [58,59,60,61,62] but did not occur in our study. Furthermore, the incidence of pulmonary complications was not higher in the NT group, thus disconfirming previous findings [13,35,36,37] but probably reflecting the relatively short duration of tube insertion in our study (2-3 days). In summary, with the exception of the two cases of intraoperative complications (hemorrhage), no clinically significant differences in the conventional clinical outcome between the test groups were found.…”

Section: Discussionsupporting

confidence: 48%

“…An extensive literature search revealed only seven studies that directly compared the two methods (Table 1) [32,33,34,35,36,37,38]. Only two studies were prospective, randomized clinical trials and five were retrospective analyses of medical chart data.…”

Section: Introductionmentioning

confidence: 98%

“…We therefore conducted a prospective, randomized trial comparing NT with GT, using patient self-reported experience (inconvenience, pain, QL) as the primary endpoints. [35] Retrospective 100 -In emergency operations, GT had a higher mortality and a longer hospital stay -NT had a higher incidence of atelectasis Morris et al 1974 [36] Retrospective 205 -NT had more pulmonal infections, wound dehiscences and a longer hospital stay Egghard et al 1993 [37] Retrospective 57 -NT had more pulmonal infections and higher rates of postoperative ileus Sittges-Serra et al 1984 [38] Prospective 66 -GT had a longer hospital stay -NT had more local mechanical complications -A no-decompression control group had higher volume of the stomach (X-ray)…”

Section: Introductionmentioning

confidence: 99%

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Nasogastric tube versus gastrostomy tube for gastric decompression in abdominal surgery: a prospective, randomized trial comparing patients' tube-related inconvenience

Sebastian

Koller

Plaul

et al. 2001

Langenbeck's Arch Surg

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This prospective randomized trial supports the clinical observation that NT causes more subjective inconvenience than GT. In cases when a prolonged postoperative ileus is expected, decisions for a prophylactic decompressing tube system have to weigh up the possibilities of different averse clinical as well as subjective outcomes. It is then preferable to include patients' preferences in the individual decision making process (shared-decision making).

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Section: Discussionsupporting

confidence: 48%

Section: Introductionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Nasogastric tube versus gastrostomy tube for gastric decompression in abdominal surgery: a prospective, randomized trial comparing patients' tube-related inconvenience

Sebastian

Koller

Plaul

et al. 2001

Langenbeck's Arch Surg

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“…In an older retrospective report of subjects operated on for abdominal aortic aneurysm, the frequency of ''chest'' infections was lower in those who underwent performance of gastrostomy intra-operatively than in patients with a nasogastric tube [19].…”

Section: Discussionmentioning

confidence: 92%

Early gastrostomy reduces the rate of ventilator-associated pneumonia in stroke or head injury patients

Kostadima

Kaditis²,

Alexopoulos³

et al. 2005

Eur Respir J

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Presence of a nasogastric tube is a risk factor for the development of ventilatorassociated pneumonia (VAP). Alternatively, gastrostomy can be used for administration of enteral feedings.To determine whether early performance of gastrostomy affects frequency of VAP, a randomised, controlled study was carried out in patients mechanically ventilated for stroke or head injury. In the gastrostomy group, patients underwent the procedure within 24 h of intubation. A nasogastric tube was inserted in controls. Individual subjects were studied for 3 weeks.In total, 20 subjects (mean age 48¡15.2 yrs) were allocated to the gastrostomy group, and 21 to the control group (46.6¡15.4 yrs). Of these groups, two (10%) and eight (38.1%) developed VAP, respectively. Four patients with gastrostomy and three controls did not complete the study (due to weaning from ventilatory support or death). After excluding these subjects, difference in VAP frequency persisted: two out of 16 subjects with gastrostomy had VAP (12.5%) versus eight out of 18 controls (44.4%). There were no differences in duration of hospitalisation or mortality between the two groups.In conclusion, in patients mechanically ventilated for stroke or head injury early gastrostomy is associated with a lower frequency of ventilator-associated pneumonia compared with a nasogastric tube.

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Amputation for vascular disease

Jamieson

Hill

1976

Journal of British Surgery

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Amputation for peripheral ischaemia still has a depressingly high early and late mortality, and morbidity and the end result are usually less than satisfactory. Individual surgeons probably see too few amputees to treat them with maximal efficiency, and these patients create a large burden on beds and resources. There is room for improvement in all aspects of our management of amputees. Primary healing rates might be better with less heroic attempts to obtain a distal amputation. Sepsis is lessened by the use of prophylactic antibiotics. Tight bandaging and the intra-operative fitting of prostheses are undesirable. Simple tests of skin blood pressure may aid prediction of the degree of ischaemia at the proposed level of limb section and the chances of healing. The late mortality is high and merits study of methods designed to reduce it such as long term anticoagulation.

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The value of gastrostomy in the surgery of aortic aneurysms

Cited by 10 publications

References 6 publications

Nasogastric tube versus gastrostomy tube for gastric decompression in abdominal surgery: a prospective, randomized trial comparing patients' tube-related inconvenience

Nasogastric tube versus gastrostomy tube for gastric decompression in abdominal surgery: a prospective, randomized trial comparing patients' tube-related inconvenience

Early gastrostomy reduces the rate of ventilator-associated pneumonia in stroke or head injury patients

Amputation for vascular disease

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