Removal of Nasogastric Tube Accidentally Stitched to Roux-en-Y Oesophagojejunostomy Following a Radical Gastrectomy for Stomach Cancer: Case report and review of the literature

Abstract

Nasogastric tubes (NGTs) are important for feeding, stenting and decompression after gastrointestinal surgeries, particularly in the upper gastrointestinal tract. Resistance in the removal of a NGT is a rare surgical complication and may be due to a knot in the tube or a stitch anchoring the tube to an anastomosis. We report a 41-year-old male patient who was admitted to the King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia, in 2015 with stomach cancer. He underwent a radical total gastrectomy with a Roux-en-Y oesophagojejunostomy. One week after the surgery, removal of the NGT was attempted; however, this was very difficult and the proximal end of the tube was cut off as a temporary measure. Six weeks later, an upper gastrointestinal tract endoscopy revealed that the distal end of the NGT had been accidentally stitched to the Roux-en-Y oesophagojejunostomy. The stitch was removed and the rest of the NGT was successfully extracted using a snare.

Endoscopic Removal of A Nasogastric Tube Accidentally Stitched During Bariatric Surgery: A Case Report and Review of the Literature

“…Some authors suggested performing endoscopy only after the healing time for gastrointestinal anastomosis, estimated to be of 2-3 weeks, but we also found a report of endoscopic removal of NGT performed after 6 weeks, after a temporary measure [1,2,6,7,9]. More recently, earlier endoscopic attempts have been described, from 6-7 days after surgery, up to 1-2 days postoperative [4,5,[10][11][12][13].…”

“…We made a review of the literature to find all published reports of endoscopic removal of a NGT mistakenly sutured during surgery. Thirteen case reports have been described in several interventions, such as the Nissen fundoplication, Dor fundoplication, partial gastric resection total gastrectomy, oesophageal resection, oesophago-colongastroplasty, robotically assisted laparoscopic biliopancreatic diversion with duodenal switch, open abdominal surgery for primary repair of a gastro-duodenal perforation, laparorobotic pancreaticoduodenectomy [1][2][3][4][5][6][7][8][9][10][11][12][13]. Six of them were performed manually [1,3,4,10,11,14].…”

“…Studies are summarized in (Table 1). [10] Robotically assisted laparoscopic biliopancreatic diversion with duodenal switch 1 day Endoscopic cutter through sideview ERCP scope Galasso et al 2013 [9] Surgery on a proximal colon-gastric anastomosis 3 weeks Homemade endoscopic guillotine: combination of the metal sheath of a mechanical lithotriptor and a polypectomy snare Knežević et al 2013 [5] Gastric resection, with Billroth II 7 days Precut papilliotome needle and alligator jaw foreign body forceps Kim et al 2016 [11] Repair of a duodenal perforation 6 days Endoscopic loop cutter Morais et al 2017 [14] Gastric ulcer suture 7 days Hot biopsy forceps Azzam et al 2018 [7] Total gastrectomy with a Roux-en-Y oesophagojejunostomy 6 weeks Endoscopic snare…”

Eventos Adversos Relacionados À Sonda Enteral: Revisão Integrativa

“…Não relata evolução clínica. Arábia Saudita 2018 (58) Inserção pré-gastrectomia total. À retirada, a sonda apresentou resistência.…”