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.
Dr Nelson and colleagues conducted a meta-analysis of published studies examines the efficacy of this practice after abdominal surgery in achieving each of these goals.
The investigative team included search terms such as ‘nasogastric, tubes, randomized'.
|Patients not having a nasogastric tube routinely inserted experience an earlier return of bowel function|
|British Journal of Surgery|
The team explored Medline, Embase, the Cochrane Controlled Trials Register and references from included studies.
The researchers included eligible studies that had patients with abdominal operations of any type, emergency or elective.
The team reported that patients had to be randomized before completion of the operation to receive a nasogastric tube kept in place until intestinal function had returned or to selective use of a tube with early removal.
The researchers identified a total of 28 studies that fulfilled the eligibility criteria.
The eligible studies included 4194 patients, of which 2108 were randomized to routine tube and 2087 randomized to selective or no tube.
The team found that those not having a nasogastric tube routinely inserted experienced an earlier return of bowel function, and a decrease in pulmonary complications.
Patients without routinely inserted nasogastric tubes also showed an increase in wound infection and ventral hernia.
The researchers observed that anastomotic leakage was similar in the 2 groups.
Dr Nelson concludes, “Routine nasogastric decompression does not accomplish any of its intended goals and so should be abandoned in favour of selective use of the nasogastric tube.”