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Randomized Controlled Trial for Evaluation of the Routine Use of Nasogastric Tube Decompression After Elective Liver Surgery

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

The value of routine nasogastric tube (NGT) decompression after elective hepatetctomy is not yet established. Previous studies in the setting of non-liver abdominal surgery suggested that the use of NGT decreased the incidence of nausea or vomiting, while increasing the frequency of pulmonary complications.

Study Design

Out of a total of 284 consecutive patients undergoing hepatectomy, 210 patients were included in this study. The patients were randomized to a group that received NGT decompression (NGT group; n = 108), in which a NGT was left in place after surgery until the patient passed flatus or stool, or a group that did not receive NGT decompression (no-NGT group; n = 102), in which the NGT was removed at the end of surgery.

Results

There were no differences between the NGT group and no-NGT group in terms of the overall morbidity (34.3 vs 35.3 %; P = 0.99), incidence of pulmonary complications (18.5 vs 19.5 %; P = 0.84), frequency of postoperative vomiting (6.5 vs 7.8 %; P = 0.70), time to start of oral intake (median (range) 3 (2–6) vs 3 (2–6) days; P = 0.69), or postoperative duration of hospital stay (19 (7–74) vs 18 (9–186) days; P = 0.37). In the no-NGT group, three patients required reinsertion of the tube 0 (0–3) days after surgery. In the NGT group, severe discomfort was recorded in five patients.

Conclusions

Routine NGT decompression after elective hepatectomy does not appear to have any advantages.

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Authors and Affiliations

  1. Department of Hepatobiliary-Pancreatic Surgery, Juntendo University School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan

    Hirofumi Ichida, Hiroshi Imamura, Jiro Yoshimoto, Hiroyuki Sugo, Yoichi Ishizaki & Seiji Kawasaki

Authors
  1. Hirofumi Ichida
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  2. Hiroshi Imamura
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  3. Jiro Yoshimoto
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  4. Hiroyuki Sugo
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  5. Yoichi Ishizaki
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  6. Seiji Kawasaki
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Corresponding author

Correspondence to Hiroshi Imamura.

Ethics declarations

The study protocol was approved by the institutional review board of Juntendo University Hospital. Written informed consent was obtained from all the patients participating in the study.

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Ichida, H., Imamura, H., Yoshimoto, J. et al. Randomized Controlled Trial for Evaluation of the Routine Use of Nasogastric Tube Decompression After Elective Liver Surgery. J Gastrointest Surg 20, 1324–1330 (2016). https://doi.org/10.1007/s11605-016-3116-0

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  • DOI: https://doi.org/10.1007/s11605-016-3116-0

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