Hirofumi Ichida1, Hiroshi Imamura2, Jiro Yoshimoto1, Hiroyuki Sugo1, Yoichi Ishizaki1, Seiji Kawasaki1. 1. Department of Hepatobiliary-Pancreatic Surgery, Juntendo University School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan. 2. Department of Hepatobiliary-Pancreatic Surgery, Juntendo University School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan. himamura-tky@umin.ac.jp.
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.
RCT Entities:
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.
Authors: P R Savassi-Rocha; S A Conceicão; J T Ferreira; M T Diniz; I C Campos; V A Fernandes; D Garavini; L P Castro Journal: Surg Gynecol Obstet Date: 1992-04
Authors: Carlo V Feo; Barbara Romanini; Davide Sortini; Riccardo Ragazzi; Paolo Zamboni; Gian C Pansini; Alberto Liboni Journal: ANZ J Surg Date: 2004-05 Impact factor: 1.872