Prophylactic nasogastric decompression after abdominal surgery

Nelson, Richard L.; Edwards, S. Albert; Tse, Bonnie

doi:10.1002/14651858.cd004929

Cited by 37 publications

(36 citation statements)

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“…Increased pulmonary complications and longer time to return of bowel function were observed in patients with routine nasogastric tube [75]. One RCT (including 200 patients) confirmed those results after hepatectomy [76].…”

Section: Prophylactic Nasogastric Intubationmentioning

confidence: 79%

Guidelines for Perioperative Care for Liver Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations

et al. 2016

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Background Enhanced Recovery After Surgery (ERAS) is a multimodal pathway developed to overcome the deleterious effect of perioperative stress after major surgery. In colorectal surgery, ERAS pathways reduced perioperative morbidity, hospital stay and costs. Similar concept should be applied for liver surgery. This study presents the specific ERAS Society recommendations for liver surgery based on the best available evidence and on expert consensus. Methods A systematic review was performed on ERAS for liver surgery by searching EMBASE and Medline. Five independent reviewers selected relevant articles. Quality of randomized trials was assessed according to the Jadad score and CONSORT statement. The level of evidence for each item was determined using the GRADE system. The Delphi method was used to validate the final recommendations. Results A total of 157 full texts were screened. Thirty-seven articles were included in the systematic review, and 16 of the 23 standard ERAS items were studied specifically for liver surgery. Consensus was reached among experts after 3 rounds. Prophylactic nasogastric intubation and prophylactic abdominal drainage should be omitted. The use of postoperative oral laxatives and minimally invasive surgery results in a quicker bowel recovery and shorter hospital stay. Goal-directed fluid therapy with maintenance of a low intraoperative central venous pressure induces faster recovery. Early oral intake and mobilization are recommended. There is no evidence to prefer epidural to other types of analgesia. Conclusions The current ERAS recommendations were elaborated based on the best available evidence and endorsed by the Delphi method. Nevertheless, prospective studies need to confirm the clinical use of the suggested protocol.

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Section: Prophylactic Nasogastric Intubationmentioning

confidence: 79%

Guidelines for Perioperative Care for Liver Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations

et al. 2016

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“…It is important to evaluate this, particularly as implementation of this multidisciplinary protocol in clinical practice has proven difficult. 30,31 Laparoscopy as well as FT care is more expensive than open surgery and standard care. Obviously, it was intended to apply all FT elements in the patients randomized to the FT group.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopy in Combination with Fast Track Multimodal Management is the Best Perioperative Strategy in Patients Undergoing Colonic Surgery

Vlug¹,

Wind²,

Hollmann³

et al. 2011

Annals of Surgery

695

512

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“…The presence of an NGT has clearly been identified as a risk factor for aspiration pneumonia, which is associated with significant morbidity and mortality (Kirby et al 1995; Langmore et al 1998; Gomes et al 2003). In addition, a large Cochrane review encompassing over 5000 patients demonstrated that the routine use of a NGT after abdominal surgery is associated with delayed return of bowel function, increased pulmonary complications, and no difference in anastomotic leak (Nelson et al 2007). Therefore, the routine use of NGT drainage for decompression after elective CRS is not recommended.…”

Section: Methodsmentioning

confidence: 99%

American Society for Enhanced Recovery (ASER) and Perioperative Quality Initiative (POQI) joint consensus statement on prevention of postoperative infection within an enhanced recovery pathway for elective colorectal surgery

Holubar

Hedrick²,

Gupta

et al. 2017

Perioper Med

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BackgroundColorectal surgery (CRS) patients are an at-risk population who are particularly vulnerable to postoperative infectious complications. Infectious complications range from minor infections including simple cystitis and superficial wound infections to life-threatening situations such as lobar pneumonia or anastomotic leak with fecal peritonitis. Within an enhanced recovery pathway (ERP), there are multiple approaches that can be used to reduce the risk of postoperative infections.MethodsWith input from a multidisciplinary, international group of experts and through a focused (non-systematic) review of the literature, and use of a modified Delphi method, we achieved consensus surrounding the topic of prevention of postoperative infection in the perioperative period for CRS patients.DiscussionAs a part of the first Perioperative Quality Initiative (POQI-1) workgroup meeting, we sought to develop a consensus statement describing a comprehensive, yet practical, approach for reducing postoperative infections, specifically for CRS within an ERP. Surgical site infection (SSI) is the most common postoperative infection. To reduce SSI, we recommend routine use of a combined isosmotic mechanical bowel preparation with oral antibiotics before elective CRS and that infection prevention strategies (also called bundles) be routinely implemented as part of colorectal ERPs. We recommend against routine use of abdominal drains. We also give consensus guidelines for reducing pneumonia, urinary tract infection, and central line-associated bloodstream infection (CLABSI).

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Prophylactic nasogastric decompression after abdominal surgery

Cited by 37 publications

References 0 publications

Guidelines for Perioperative Care for Liver Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations

Guidelines for Perioperative Care for Liver Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations

Laparoscopy in Combination with Fast Track Multimodal Management is the Best Perioperative Strategy in Patients Undergoing Colonic Surgery

American Society for Enhanced Recovery (ASER) and Perioperative Quality Initiative (POQI) joint consensus statement on prevention of postoperative infection within an enhanced recovery pathway for elective colorectal surgery

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