Safety of omitting nasogastric decompression after esophagectomy: a propensity score-matched study

Nasogastric (NG) decompression is routinely performed after esophagectomy. However, whether it aids postoperative recovery is still controversial. This study aimed to assess the effects of NG decompression on postoperative complications after esophagectomy.

Data of 1,489 consecutive patients who underwent esophagectomy between January 2019 and December 2020 were retrospectively analyzed. All patients were assigned to two groups based on whether they had undergone NG decompression or not. We conducted a propensity score matching (PSM) analysis to minimize the effect of potential confounders.

In total, 1,466 patients (including 1,235 patients with NG tubes and 231 without NG tubes) were included in the study, and 219 pairs were successfully matched. After PSM analysis, there was no difference in morbidity and mortality between the two groups. Postoperative hospital stay in the non-NG tube group was shorter than that in the NG tube group (8 vs. 10 days, P<0.001). The incidence of pneumonia and anastomotic leakage showed no significant differences (13.2% vs. 17.8%, P=0.235 for pneumonia; 13.7% vs. 11.0%, P=0.460 for anastomotic leakage). For patients who developed anastomotic leakage after surgery, the leakage developed earlier in the non-NG group (6 vs. 8 days, P=0.033) than in the NG group. However, no significant between-group differences were observed in the postoperative hospital stay and severity of leakage.

Routine NG decompression may not confer any discernible benefits for patients who have undergone esophagectomy. As such, the omission of this procedure could be considered in postoperative care.