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Elective colon and rectal surgery without nasogastric decompression. A prospective, randomized trial
B G Wolff1, J H Pembeton, J A van Heerden
1Section of Colon and Rectal Surgery, Mayo Medical School, Mayo Clinic, Rochester, Minnesota 55905.
Annals of Surgery
|June 1, 1989
Summary
Routine nasogastric decompression after colorectal surgery is not beneficial. While it reduces nausea and vomiting, it does not impact hospital stay or complications, making it unnecessary for most patients.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Clinical Trials
Background:
- Nasogastric (NG) decompression is a common practice following colorectal surgery.
- The clinical benefit of routine NG decompression in this patient population remains debated.
Purpose of the Study:
- To evaluate the efficacy of routine nasogastric decompression in patients undergoing elective colorectal surgery.
- To determine if routine NG decompression impacts patient outcomes, including symptom severity and hospital length of stay.
Main Methods:
- A prospective, randomized controlled trial involving 535 patients undergoing elective colorectal surgery.
- Patients were randomized to either routine NG decompression or no decompression.
- Exclusion criteria included emergency surgery, peritonitis, and other specific comorbidities.
Main Results:
- Patients not receiving routine NG decompression experienced significantly more abdominal distention, nausea, and vomiting.
- 13% of non-decompressed patients required subsequent NG tube insertion compared to 5% in the routine decompression group.
- No significant differences were observed in hospitalization length, bleeding, respiratory infections, wound complications, or reoperation rates.
Conclusions:
- Routine nasogastric decompression is not warranted after elective colon and rectal surgery.
- Despite increased minor symptoms like nausea and vomiting without decompression, the overall benefits do not justify its routine use.