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Does the avoidance of nasogastric decompression following elective abdominal colorectal surgery affect the incidence of incisional hernia?

Results of a prospective, randomized trial

  • Original Contributions
  • Published:
Diseases of the Colon & Rectum

Abstract

PURPOSE: In a previous, prospective, randomized study of the use of nasogastric tubes in patients undergoing elective abdominal colorectal surgery, we found that patients who did not have nasogastric (NG) decompression postoperatively had a significantly higher rate of abdominal distention, nausea, and vomiting. Patients from that study have now been followed for a median duration of 5.3 years to evaluate whether this elevation in perioperative intra-abdominal pressure would subsequently lead to an increased incidence of incisional hernia. RESULTS: Of the 251 patients who received NG decompression, 8 (3.2 percent) developed incisional hernias compared with 15 (6.6 percent) of 229 patients who were not decompressed (P =0.085). CONCLUSIONS: The increase in postoperative abdominal distention and vomiting that occurs in patients who do not receive NG decompression does not lead to a significantly increased incidence of incisional hernia. Furthermore, we continue to support avoidance of routine prophylactic post-operative nasogastric decompression in uncomplicated, elective abdominal colorectal surgery.

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References

  1. Levin AL. A new gastroduodenal catheter. JAMA 1921;76:1007–9.

    Google Scholar 

  2. Wangensteen OH, Paine JR. Treatment of acute intestinal obstruction by suction with the duodenal tube. JAMA 1933;101:1532–9.

    Google Scholar 

  3. Gerber A. An appraisal of paralytic ileus and the necessity of postoperative gastrointestinal suction. Surg Gynecol Obstet 1963;117:294–6.

    PubMed  Google Scholar 

  4. Wolff BG, Pemberton JH, vanHeerden JA,et al. Elective colon and rectal surgery without nasogastric decompression: a prospective, randomized trial. Ann Surg 1989;209:670–4.

    PubMed  Google Scholar 

  5. Savassi-Rocha PR, Conceicao SA, Ferreira JT,et al. Evaluation of the routine use of the nasogastric tube in digestive operation by a prospective controlled study. Surg Gynecol Obstet 1992;174:317–20.

    PubMed  Google Scholar 

  6. Nathan BN, Pain JA. Nasogastric suction after elective abdominal surgery: a randomized study. Ann R Coll Surg Engl 1991;73:291–4.

    PubMed  Google Scholar 

  7. Michowitz M, Chen J, Waizbard E, Bawnik JB. Abdominal operations without nasogastric tube decompression of the gastrointestinal tract. Am Surg 1988;54:672–5.

    PubMed  Google Scholar 

  8. Cunningham J, Temple WJ, Langevin JM, Kortbeek J. A prospective randomized trial of routine postoperative nasogastric decompression in patients with bowel anastomosis. Can J Surg 1992;35:629–32.

    PubMed  Google Scholar 

  9. Petrelli NJ, Stulc JP, Rodriguez-Bigas M, Blumenson L. Nasogastric decompression following elective colorectal surgery: a prospective randomized study. Am Surg 1993;59:632–5.

    PubMed  Google Scholar 

  10. Bauer JJ, Gelernt IM, Salky BA, Kreel I. Is routine postoperative nasogastric decompression really necessary? Ann Surg 1985;201:233–6.

    PubMed  Google Scholar 

  11. Jamieson WG, Derose G, Harris KA. Routine nasogastric decompression after abdominal surgery? Can J Surg 1992;35:577–8.

    PubMed  Google Scholar 

  12. Santora TA, Roslyn JJ. Incisional hernia. Surg Clin North Am 1193;73:557–70.

  13. Fischer JD, Turner FW. Abdominal incisional hernias: a ten-year review. Can J Surg 1974;17:202–4.

    PubMed  Google Scholar 

  14. Bucknell TE, Cox PJ, Ellis H. Burst abdomen and incisional hernia: a prospective study of 1129 major laparotomies. BMJ 1982;284:931–3.

    PubMed  Google Scholar 

  15. Mudge M, Hughes LE. Incisional hernia: a 10 year prospective study of incidence and attitudes. Br J Surg 1985;72:70–1.

    PubMed  Google Scholar 

  16. Ellis H, Gajaraj H, George CD. Incisional hernias: when do they occur? Br J Surg 1983;70:290–1.

    PubMed  Google Scholar 

  17. Kendall SW, Brennan TG, Guillou PJ. Suture length to wound ratio and the integrity of midline and lateral paramedian incisions. Br J Surg 1991;78:705–7.

    PubMed  Google Scholar 

  18. Blomstedt B, Welin-Berger T. Incisional hernias. Acta Chir Scand 1972;138:275–8.

    PubMed  Google Scholar 

  19. Read RC, Yonder G. Recent trends in the management of incisional herniation. Arch Surg 1989;124:485–8.

    PubMed  Google Scholar 

  20. Hesselink VJ, Luijendijk RW, deWilt JH, Heide R, Jeekel J. An evaluation of risk factors in incisional hernia recurrence. Surg Gynecol Obstet 1993;176:228–34.

    PubMed  Google Scholar 

  21. Pollock AV, Evans M. Early prediction of late incisional hernias. Br J Surg 1989;76:953–4.

    PubMed  Google Scholar 

  22. Dare FO, Lawall OO. Experience with 29 cases of female ventral incisional hernias in Ile-Ife, Nigeria. Int J Gynaecol Obstet 1991;36:29–32.

    PubMed  Google Scholar 

  23. Houck JP, Rypins EB, Sarhef IJ, Juler GL, Shimoda KJ. Repair of incisional hernia. Surg Gynecol Obstet 1989;169:397–9.

    PubMed  Google Scholar 

  24. Wasiljew BK, Winchester DP. Experience with continuous absorbable suture in the closure of abdominal incisions. Surg Gynecol Obstet 1982;154:378–80.

    PubMed  Google Scholar 

  25. Urschel JD, Scott PG, Williams HT. Etiology of late developing incisional hernias—the possible role of mechanical stress. Med Hypotheses 1988;25:31–4.

    PubMed  Google Scholar 

  26. Wissing J, Vroonhoven TJ, Schattenkerk ME, Veen HF, Ponsen RJ, Jeekel J. Fascia closure after midline laparotomy: results of a randomized trial. Br J Surg 1987;74:738–41.

    PubMed  Google Scholar 

  27. Richards PC, Balch CM, Aldrete JS. Abdominal wound closure: a randomized prospective study of 571 patients comparing continuousversus interrupted suture techniques. Ann Surg 1983;197:238–43.

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Colon and Rectal Surgery, Mayo Clinic, 55905, Rochester, Minnesota

    Daniel P. Otchy M.D.,  Bruce G. Wolff M.D., Jonathan A. van Heerden M.D., Duane M. Ilstrup M.S., Amy L. Weaver M.S. & Lorraine D. Winter R.N.

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  1. Daniel P. Otchy M.D.
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  2. Bruce G. Wolff M.D.
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  3. Jonathan A. van Heerden M.D.
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  4. Duane M. Ilstrup M.S.
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  5. Amy L. Weaver M.S.
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  6. Lorraine D. Winter R.N.
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Otchy, D.P., Wolff, B.G., van Heerden, J.A. et al. Does the avoidance of nasogastric decompression following elective abdominal colorectal surgery affect the incidence of incisional hernia?. Dis Colon Rectum 38, 604–608 (1995). https://doi.org/10.1007/BF02054119

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