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Comparative Analysis of Efficacy of Intraoperative Decompression with Nasogastric and Nasojejunal Tubes in Patients with Malignant Small Bowel Obstruction

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Abstract

Background

Nasointestinal decompression was implemented into clinical practice in 1930s. Earlier clinical trials have confirmed the efficacy of nasointestinal tubes in treating adhesive small bowel obstructions. A recent study showed controversial results: efficacy after nasogastric intervention was not less efficient compared to nasointestinal decompression. Hydrophilic silicon triple lumen tubes used for intestinal decompression were introduced in 2003. A variety of modifications were introduced and applied in clinical practice. Our study attempts to compare the decompression efficacy between the modern ileus tube and nasogastric tubes used for decompression in patients with malignant bowel obstruction.

Methods

A total of 132 consecutive patients with intestinal obstruction were included in this study. There was no significant difference between the two groups with regard to clinical characteristics and laboratory variables documented on admission. The endoscopically inserted intestinal tube was used for gastrointestinal decompression in 64 patients, and nasogastric tube was applied in 68 patients. The therapeutic efficacy of applied strategies was compared between the two groups using Chi-squared test.

Results

Compared with the strategy applying nasogastric tubes, the group of patients treated with intestinal tube showed significantly shorter time for surgical rehabilitation (4.8 ± 2.2 d vs 9.6 ± 4.8 d). Significant difference was registered in laboratory test results (P < 0.01). In the study group, the output of drainage and the length of hospital stay were significantly shorter compared to the control (P < 0.05).

Conclusion

Nasointestinal decompression used in the surgical management of small intestinal obstruction with malignancy has significantly higher efficacy compared to nasogastric decompression.

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Correspondence to A. A. Mirijanyan.

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The authors declare that they have no conflict of interest.

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The study was approved by the YSMU research ethics committee.

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Informed consent was obtained from all individual participants included in the study.

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Mirijanyan, A.A., Grigoryan, K.H. & Mirijanyan, M.M. Comparative Analysis of Efficacy of Intraoperative Decompression with Nasogastric and Nasojejunal Tubes in Patients with Malignant Small Bowel Obstruction. Indian J Surg (2020). https://doi.org/10.1007/s12262-020-02091-4

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Keywords

  • Intestinal obstruction
  • Nasointestinal decompression
  • Intoxication markers