[Necessity of routine nasogastric decompression after gastrectomy for gastric cancer: a meta-analysis]

To evaluate the necessity of routine nasogastric decompression after radical gastrectomy for gastric cancer with systematic review and Meta-analysis.

The literature databases prior to September 2011 were extensively searched to retrieve the randomized controlled trials (RCT) with a relevance of study goal. The inclusion and exclusion criteria were formulated. After quality evaluation, the data were extracted. The Cochrane collaboration RevMan 5.1 version software was used for Meta-analysis.

Seven RCT studies fulfilled the inclusion criteria for Meta-analysis. The total sample size of these studies was 871 cases. Those without a nasogastric tube routinely inserted experienced a marginal earlier time to flatus [weighted mean difference (WMD) = 0.10 days, 95% confidence interval (CI) 0.00 - 0.30, P = 0.05], a significant earlier time to oral diet [WMD = 0.43 days, 95%CI 0.25 - 0.61, P < 0.01], a significant shorter hospital stay [WMD = 0.60 days, 95%CI 0.15 - 1.18, P = 0.01) and a marginal decrease in pulmonary complications [relative risk (RR) = 1.30, 95%CI 1.00 - 1.68, P = 0.05)]. The postoperative rates of anastomotic leakage, morbidity and mortality were similar between two groups.

Except for severe vomiting or abdominal distension, nasogastric tubes should not be used routinely in gastric cancer patients undergoing radical surgery.