Abstract
Objectives
Nasogastric tubes (NGT) have been routinely used after abdominal procedures, largely due to the accepted tradition, especially in China. However, studies recently questioned the role of routine NGT intubation by stating that it was overused and many complications occurred from its use.
Methods
Herein, we performed a systematic review and a meta-analysis evaluating the role of NGT in decompression after elective colon and rectum surgery.
Results
Four fixed-effect models and three randomized-effect models were used for statistics pooling of the relative risks (RR) for the different outcomes. A total of seven articles (1,416 patients) fulfilled the inclusion criteria. Patients in NGT group had less vomiting (p < 0.00001; RR = 2.85; 95% CI [2.12, 3.83]), less nasogastric tube replacement (p < 0.00001; RR = 3.90; 95% CI [2.34, 6.52]), but more pharyngolaryngitis (p < 0.00001 RR = 0.14; 95% CI [0.08, 0.26]) and more respiratory infection (p = 0.004; RR = 0.37; 95% CI [0.19, 0.74]). No statistically significant differences were noted in nausea, wound infection or intestinal obstruction.
Conclusion
In conclusion, routine NGT decompression did no good to the time to return gastrointestinal function, but increased the morbidity of pharyngolaryngitis and respiratory infection significantly. Routine NGT was not recommended for patients after elective colon and rectum surgery.
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References
Cadili A, de Gara C (2008) Can surgeon familiarization with current evidence lead to a change in practice? A prospective study. Int J Surg 6(5):378–381
Nelson R, Tse B, Edwards S (2005) Systematic review of prophylactic nasogastric decompression after abdominal operations. Br J Surg 92(6):673–680
Zhou T, Wu XT, Zhou YJ, Huang X, Fan W (2006) Early removing gastrointestinal decompression and early oral feeding improve patients' rehabilitation after colorectostomy. World J Gastroenterol 12(15):2459–2463
Olesen KL, Birch M, Bardram L, Burcharth F (1984) Value of nasogastric tube after colorectal surgery. Acta Chir Scand 150:251–253
Ibrahim AA, Abrego D, Issiah IA, Smith DW (1977) Is postoperative proximal decompression a necessary complement to elective colon resection? S Med J 70:1070–1071
Meltvedt R Jr, Knecht B, Gibbons G, Stahler C, Stojowski A, Johansen K (1985) Is nasogastric suction necessary after elective colon resection? Am J Surg 149(5):620–622
Racette DL, Chang FC, Trekell ME, Farha GJ (1987) Is nasogastric intubation necessary in colon operations? Am J Surg 154(6):640–642
Yang Z, Zheng Q, Wang Z (2008) Meta-analysis of the need for nasogastric or nasojejunal decompression after gastrectomy for gastric cancer. Br J Surg 95(7):809–816
Pessaux P, Regimbeau JM, Dondero F, Plasse M, Mantz J (2007) Randomized clinical trial evaluating the need for routine nasogastric decompression after elective hepatic resection. Br J Surg 94(3):297–303
Nelson R, Edwards S, Tse B (2007) Systematic review of prophylactic nasogastric decompression after abdominal operations. Cochrane Database Syst Rev 3:CD004929
Avassi-Rocha PR, Conceicão SA, Ferreira JT, Diniz MT, Campos IC, Fernandes VA et al (1992) Evaluation of the routine use of the nasogastric tube in digestive operation by a prospective controlled study. Surg Gynecol Obstet 174(4):317–320
Cheadle WG, Vitale GC, Mackie CR, Cuschieri A (1985) Prophylactic postoperative nasogastric decompression. A prospective study of its requirement and the influence of cimetidine in 200 patients. Ann Surg 202:361–366
Jottard K, Hoff C, Maessen J, van-Ramshorst B, van-Berlo CL (2009) Life and death of the nasogastric tube in elective colonic surgery in the Netherlands. Clin Nutr 28(1):26–28
Juhl GA, Conners GP (2005) Emergency physicians' practices and attitudes regarding procedural anaesthesia for nasogastric tube insertion. Emerg Med J 22(4):243–245
Gerber A (1963) An appraisal of paralytic ileus and the necessity of post operative gastrointestinal suction. Surg Gynecol Obstet 117:294
Colvin DB, Lee W, Eisenstat TE, Rubin RJ, Salvati EP (1986) The role of nasointestinal intubation in elective colonic surgery. Dis Colon Rectum 29(5):295–299
Wolff BG, Pembeton JH, van Heerden JA, Beart RW, Nivatvongs S (1989) Elective colon and rectal surgery without nasogastric decompression. A prospective randomized trial. Ann Surg 209(6):670–673
Liu WZ, Zhang W, Ni Y (1996) A clinical study of intestinal and colorectal surgery without nasogastric decompression. Mod Diag Treat 7(4):206–207
Ortiz H, Armendariz P, Yarnoz C (1996) Is early postoperative feeding feasible in elective colon and rectal surgery? Int J Colorectal Dis 11(3):119–121
Feo CV, Romanini B, Sortini D, Ragazzi R, Zamboni P (2004) Early oral feeding after colorectal resection: a randomized controlled study. ANZ J Surg 74(5):298–301
Lei WZ, Zhao GP, Li K, Cheng Z, Wang TC (2005) Evaluation of clinical necessity of gastrointestinal decompression after excision and anastomosis of lower digestive tract. Chin J Gastrointest Surg 8(3):203–205
Hasenberg T, Rattler P, Post S, Jauch KW, Senkal M et al (2006) A survey of perioperative therapy for elective colon resection in Germany. Chirur 78(9):818–826
Reissman P, Teoh TA, Cohen SM, Weiss EG, Nogueras JJ (1995) Is early oral feeding safe after elective colorectal surgery? A prospective randomized trial. Ann Surg 222(1):73–77
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Rao, W., Zhang, X., Zhang, J. et al. The role of nasogastric tube in decompression after elective colon and rectum surgery : a meta-analysis. Int J Colorectal Dis 26, 423–429 (2011). https://doi.org/10.1007/s00384-010-1093-4
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DOI: https://doi.org/10.1007/s00384-010-1093-4