Unnecessary gastric decompression in distal elective bowel anastomoses in children: a randomized study
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Published on: August 22, 2025
Roberto Davila-Perez1, Eduardo Bracho-Blanchet, Jose Manuel Tovilla-Mercado
1Pediatric Surgery, Hospital Infantil de Mexico Federico Gomez, Dr. Márquez No. 162, Col. Doctores, Delegación Cuauhtemoc, Mexico, DF, CP 06720, Mexico. robdape@rocketmail.com
Insights
Routine nasogastric drainage is unnecessary after pediatric bowel surgery. This study found no significant difference in complications, suggesting it should be used only when clinically indicated.
Area of Science:
- Pediatric Surgery
- Gastrointestinal Surgery
- Clinical Trials
Background:
- Nasogastric drainage is a common practice after gastrointestinal surgery.
- Its routine use aims to prevent complications and shorten hospital stays.
- Evidence supporting its benefit in pediatric distal bowel anastomosis is lacking.
Purpose of the Study:
- To evaluate the efficacy of nasogastric drainage in preventing postoperative complications in children undergoing distal elective bowel anastomosis.
- To determine if routine nasogastric intubation is beneficial after this specific surgical procedure in pediatric patients.
Main Methods:
- A randomized controlled trial was conducted with 60 pediatric patients.
- Patients were divided into two groups: one with a nasogastric tube (n=29) and one without (n=31).
- Postoperative complications were compared between the groups.
Main Results:
- No anastomotic leaks or enterocutaneous fistulae occurred in either group.
- There were no significant differences in abdominal distension, infection rates, or hospital stay.
- Only one patient (3.2%) in the nasogastric tube group required tube placement for persistent distension.
Conclusions:
- Routine nasogastric drainage can be safely omitted after distal elective intestinal surgery in children.
- The decision to use nasogastric drainage should be individualized based on patient condition.
- This practice change can potentially streamline postoperative care in pediatric surgery.
Background:
The goal of this study was to investigate the role of nasogastric drainage in preventing postoperative complications in children with distal elective bowel anastomosis. Nasogastric drainage has been used as a routine measure after gastrointestinal surgery in children and adults to hasten bowel function, prevent postoperative complications, and shorten hospital stay. However, there has been no study that shows in a scientific manner the benefit of nasogastric drainage in children.
Methods:
We performed a clinical, controlled, randomized trial comprising 60 children who underwent distal elective bowel anastomoses and compared postoperative complications between a group with nasogastric tube in place (n = 29) and one without it (n = 31).
Results:
Demographic data and diagnoses were comparable in both groups (P = NS). No anastomotic leaks or enterocutaneous fistulae were found in any patient. There were no significant differences between the two groups with respect to abdominal distension, infection, or hospital stay. Only one patient in the experimental group required placement of the nasogastric tube due to persistent abdominal distension (3.2%).
Conclusions:
The routine use of nasogastric drainage after distal elective intestinal surgery in children can be eliminated. Its use should depend on the individual patient's situation.
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