Nasogastric intubation and elective abdominal surgery

Sagar, P. M.; Kruegener, G. H.; MacFie, John

doi:10.1002/bjs.1800791105

Cited by 74 publications

(44 citation statements)

References 37 publications

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“…Moreover, a nasogastric tube itself may induce vomiting and is associated with several complications (more than 20 % in our study), such as nasopharyngeal soreness, otitis, sinusitis, oesophagitis, digestive bleeding, and intestinal fluid loss [15,16]. In addition, the discomfort caused by a nasogastric tube is one of the most unpleasant aspects of the postoperative course [17].…”

Section: Discussionmentioning

confidence: 68%

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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Section: Discussionmentioning

confidence: 68%

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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“…Peritoneal contamination, systemic ailments and electrolyte imbalances. Moreover neither is there substantial period of small gut paralysis after surgery nor does intubation effectively decompress it, on the other hand it may even promote ileus [6]. Moss demonstrated the ineffectiveness of gastric aspiration and recommended immediate post operative elemental feeding [15,16].…”

Section: Mjafi Vol 56 No I 2000mentioning

confidence: 99%

“…Studies have demonstrated satisfactory result without routine use in upper and lower abdominal operations [4,5]. Prophylactic intubation can not only cause complications but may even promote ileus [6]. However, despite lack of a rational basis, nasogastric intubation is commonly practised in abdominal surgery.…”

mentioning

confidence: 99%

Nasogastric Decompression in Cholecystectomy, Is It Necessary?

Mehrotra

2000

Medical Journal Armed Forces India

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Nasogastric decompression seems to be widely employed in cholecystectomiesdespite evidence to the contrary. Based on a questionnaire given to 100 surgeons routinely doing cholecystectomies we found decompression being employed by the majority. 43% were unwilling to change their protocol. Our prospective randomised controUed trial of 162 cholecystectomies was done to assess intubation morbidity, related complications and influence on recovery. The objective was to determine if nasogastric decompression was scientifically based or conjectural. 130 patients underwent elective surgery and 32 required surgery for acute cholecystitis or associated common bile duct exploration. Both groups were randomised into tube and no-tube groups. The incidence of nausea, vomiting, distension and respiratory complications were noted and revealed no statistically significant group differences. No tube groups had earlier return of bowel motility, required lesser parenteral support and were discharged earlier compared to intubated patients. Out of81 patients without decompression, only 7(8.6%) needed intubation due to vomiting whereas 2(3%) intubated cases required reinsertion of the tube due to ileus. Detailed analysis of these patients did not reveal any predictive criteria for selective intubation. We conclude that nasogastric decompression is used indiscriminately without scientific reasoning. Our prospective randomised trial does not favour intubation in elective or emergency setting for cholecystectomies. Intubation is needless in 92% cases and delays recovery. No criteria could be identified to preselect patients for intubation. MJAFI 2000, 56 : 17-20

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“…1,2 But prolonged nasogastric intubation is associated with complications like basal atelectasis due to poor cough reflex, aspiration pneumonia, nasal septum necrosis and loss of electrolytes. So now reserved solely for a specific indications.…”

Section: Introductionmentioning

confidence: 99%