Selective versus Routine use of Nasogastric Tube Following Abdominal Surgery

Abstract

Background: Routine use of nasogastric tubes, after abdominal operations, is intended to hasten the return of bowel function, prevent pulmonary complications, diminish the risk of anastomotic leakage, increase patient comfort and shorten hospital stay.Objectives: To investigate the efficacy of routine nasogastric decompression after abdominal surgery, in achieving each of the above goals.Patients and methods: Two hundred and twelve patients having abdominal operations of any type, emergency and elective have been reviewed prospectively over a period of three years (December 2004_December 2007) in Baghdad teaching hospital, they were randomized to receive a nasogastric tube and keep it in place until intestinal function have been returned, and those receiving no tube or immediately removed following operation. Excluded from the study, were laparoscopic surgeries , gastric and duodenal surgeries.Results: 1- Earlier return of bowel function and shorter hospital stay in the non tube group. 2-No significant statistical differences concerning the occurrence of postoperative vomiting, pulmonary complications, and anastamotic leakage. 3-There was significant discomfort in the tube group.Conclusions:Routine nasogastric decompression does not accomplish any of its intended goals and so should be abandoned in favor of selective use of nasogastric tube