A randomized controlled trial of postoperative nasogastric tube decompression in gynecologic oncology patients undergoing intra-abdominal surgery

Abstract

Postoperative nasogastric tube decompression in gynecologic oncology patients undergoing extensive intra-abdominal surgery does not appear to provide any substantial benefit but significantly increases patient discomfort. As a result of this study, we have eliminated postoperative nasogastric decompression except in highly selected circumstances, such as extensive bowel surgery in patients with prior irradiation or substantial edema from bowel obstruction.

Nasogastric Decompression for Radical Gastrectomy for Gastric Cancer: A Prospective Randomized Controlled Study

“…Moreover, nasogastric decompression has been routinely used to reduce the risk of postoperative complications such as acute gastric distension, ileus, wound dehiscence and anastomotic leak. However, in the last decade, some studies have argued against the necessity of nasogastric tube following surgeries for colorectal and gynecologic diseases [1,2,3,4,5]. …”

Does Routine Nasogastric Tube Placement After an Operation for Perforated Appendicitis Make a Difference?

“…In colorectal surgery, after several series showed no benefit with NG tubes [10 -12], multiple prospective, randomized trials have confirmed there is no role for empirically placed NG tubes after elective colon operations [1,4,6,7]. Similar data were brought forth on major abdominal operations not involving the gastrointestinal tract such as gynecologic and aortic surgery [2,3]. Furthermore, patients who underwent more proximal bowel manipulation including small intestine anastomosis have been shown to not benefit from NG tubes [5,[13][14][15].…”

“…Empiric use of an NG tube is presumed to prevent abdominal distension, vomiting, and ileus, which may complicate the postoperative course. As abundance of prospective studies performed in the adult population have universally failed to support this practice [1][2][3][4][5][6][7]. This critical data clearly supports the omission of NG tubes after abdominal surgery in adults, but only scant reports exist in pediatric surgery [8,9].…”

The current state of evidence-based pediatric surgery

“…The second example involves the routine use of nasogastric decompression after abdominal operations. The literature is replete with numerous randomized controlled trials (RCTs) that report no benefit in routine gastric decompression [62][63][64][65][66][67][68]. Furthermore, a Cochrane systemic review of the use of nasogastric tubes was published in 2007 and documented no benefit, and possible harm, with their routine use [69].…”