Is there a role for routine nasogastric intubation in elective subtotal gastrectomy for gastric malignancy?

Gigi Varghese; Sam Varghese George; Inian Samarasam

Volume : VI, Issue : X, October - 2016

Is there a role for routine nasogastric intubation in elective subtotal gastrectomy for gastric malignancy?

Gigi Varghese, Sam Varghese George, Inian Samarasam

Abstract :

OBJECTIVES: Nasogastric decompression has been routinely used in most major abdominal operations to prevent the consequences of postoperative ileus. The aim of this study was to assess the necessity for routine nasogastric decompression after subtotal gastrectomy for gastric malignancy. METHODOLOGY: A prospective randomized clinical trial included 53 patients undergoing elective subtotal gastrectomy. The patients were randomized to a group with nasogastric tube (“Routine NG” Group, n = 25) or to a group without a nasogastric tube (“No NG” Group, n = 28). Duration of return of gastrointestinal function, postoperative course, and complications were assessed and recorded. RESULTS: No statistically significant differences were found with respect to postoperative mortality or morbidity between the groups. Passage of flatus was delayed in the “routine NG” group. Incidence of vomiting was higher in the “no NG” group, although it did not attain statistical significance. Moderate to severe discomfort caused by the tube was observed in 52% of patients in the routine NG Group. Delayed insertion of a nasogastric tube was not necessary in the group with no NG tube. CONCLUSIONS: The above results suggests that routine NG tube placement is not necessary in gastric surgery especially after subtotal gastrectomy and this procedure can be safely performed without routine nasogastric decompression.