Systematic review of prophylactic nasogastric decompression after abdominal operations

Abstract

Routine nasogastric decompression does not accomplish any of its intended goals and so should be abandoned in favour of selective use of the nasogastric tube.

Clinical benefits after the implementation of a multimodal perioperative protocol in elderly patients

“…Various traditional surgical routines such as routine use of nasogastric intubation and abdominal drains when examined by the sight of the evidence based medicine paradigm have failed to demonstrate their usefulness (12,22,25) . In opposition to traditional 6-8 hours of "nil by mouth" routine, the abbreviation of pre-operative fasting not only is safe but also decreases insulin resistance (20,23) and preserves skeletal muscle mass after surgery (32) .…”

Guidelines for Perioperative Care in Elective Colonic Surgery: Enhanced Recovery After Surgery (ERAS®) Society Recommendations

“…A meta-analysis of 28 RCTs on the use of nasogastric decompression after abdominal surgery included 4,195 patients [126]. Surgery included colorectal resection (7 RCTs), gastroduodenal sugery (7 RCTs), biliary and gynaecological surgery (2 (RCTs each), vascular and trauma surgery (1 RCTs each) and mixed surgical populations (7 RCTs).…”

Complication avoidance and management in anterior lumbar interbody fusion

“…On the contrary, it may actually increase postoperative morbidity, including pulmonary complications. 13,52,53 Nelson and colleagues 53 performed a meta-analysis of 28 studies that included 2108 patients randomized to routine NGT placement and 2087 patients randomized to selective or no NGT placement. Those not having an NGT routinely inserted experienced an earlier return of bowel function (P<.001), a marginal decrease in pulmonary complications (P=.07), and marginal increases in wound infection (P=.08) and ventral hernia (P=.09).…”

“…The authors concluded that routine nasogastric decompression does not accomplish any of its intended goals and so should be abandoned in favor of selective use of the NGT. 53 Another important consideration is that patients are usually required to fast for 12 to 24 hours before surgery, and this compromised metabolic state may continue until the resolution of POI, resulting in catabolism, fatigue, and decreased immunity. Fatigue may in turn lead to decreased mobility and delayed functional recovery.…”