Skip to main content
PMC home page
Annals of Surgery logoLink to Annals of Surgery
. 1989 Jun;209(6):670–675. doi: 10.1097/00000658-198906000-00003

Elective colon and rectal surgery without nasogastric decompression. A prospective, randomized trial.

B G Wolff 1, J H Pembeton 1, J A van Heerden 1, R W Beart Jr 1, S Nivatvongs 1, R M Devine 1, R R Dozois 1, D M Ilstrup 1
PMCID: PMC1494121  PMID: 2658880

Abstract

Nasogastric (NG) decompression after colorectal surgery is practiced commonly. Our aim was to determine whether routine NG decompression benefitted patients undergoing this type of surgery. Five hundred thirty-five patients were randomized prospectively to either NG decompression or no decompression. Stratification was by type of operation and patient age. Excluded were patients who had emergency surgery with peritonitis, extensive fibrous adhesions, enterotomies, previous pelvic irradiation, intra-abdominal infection, pancreatitis, chronic obstruction. prolonged operating times, or difficult endotracheal intubation. Two hundred seventy-four patients received NG decompression (Salem sump, Argyle Co., Division of Sherwood Medical, St. Louis, MO) and two hundred sixty-one did not. There were 33 protocol violations included in the 535 patients. Patients who were not decompressed experienced significantly more abdominal distention, nausea, and vomiting than did those patients who were. Moreover, 13% required subsequent NG decompression as opposed to a reinsertion rate of 5% for patients routinely decompressed. The mean length of hospitalization for both groups was 11 days. There were no significant differences in nasopharyngeal or gastric bleeding, inability to cough effectively, respiratory infections, wound disruptions, reoperation, and wound infection rates (5%) between the two groups. We conclude that even though there is an increase in the rate of minor symptoms of nausea, vomiting, and abdominal distention, routine nasgastric decompression is not warranted after elective colon and rectal surgery.

Full text

PDF
670

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bauer J. J., Gelernt I. M., Salky B. A., Kreel I. Is routine postoperative nasogastric decompression really necessary? Ann Surg. 1985 Feb;201(2):233–236. doi: 10.1097/00000658-198502000-00017. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Burg R., Geigle C. F., Faso J. M., Theuerkauf F. J., Jr Omission of routine gastric decompression. Dis Colon Rectum. 1978 Mar;21(2):98–100. doi: 10.1007/BF02586446. [DOI] [PubMed] [Google Scholar]
  3. Cheadle W. G., Vitale G. C., Mackie C. R., Cuschieri A. Prophylactic postoperative nasogastric decompression. A prospective study of its requirement and the influence of cimetidine in 200 patients. Ann Surg. 1985 Sep;202(3):361–366. doi: 10.1097/00000658-198509000-00014. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Code C. F., Marlett J. A. The interdigestive myo-electric complex of the stomach and small bowel of dogs. J Physiol. 1975 Mar;246(2):289–309. doi: 10.1113/jphysiol.1975.sp010891. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Colvin D. B., Lee W., Eisenstat T. E., Rubin R. J., Salvati E. P. The role of nasointestinal intubation in elective colonic surgery. Dis Colon Rectum. 1986 May;29(5):295–299. doi: 10.1007/BF02554112. [DOI] [PubMed] [Google Scholar]
  6. GERBER A. AN APPRAISAL OF PARALYTIC ILEUS AND THE NECESSITY FOR POSTOPERATIVE GASTROINTESTINAL SUCTION. Surg Gynecol Obstet. 1963 Sep;117:294–296. [PubMed] [Google Scholar]
  7. Ibrahim A. A., Abrego D., Issiah I. A., Smith D. W. Is postoperative proximal decompression a necessary complement to elective colon resection? South Med J. 1977 Sep;70(9):1070–1071. doi: 10.1097/00007611-197709000-00018. [DOI] [PubMed] [Google Scholar]
  8. Ojerskog B., Kock N. G., Myrvold H. E., Akerlund S. Omission of gastric decompression after major intestinal surgery. Ann Chir Gynaecol. 1983;72(2):47–49. [PubMed] [Google Scholar]
  9. Olesen K. L., Birch M., Bardram L., Burcharth F. Value of nasogastric tube after colorectal surgery. Acta Chir Scand. 1984;150(3):251–253. [PubMed] [Google Scholar]
  10. Racette D. L., Chang F. C., Trekell M. E., Farha G. J. Is nasogastric intubation necessary in colon operations? Am J Surg. 1987 Dec;154(6):640–642. doi: 10.1016/0002-9610(87)90233-9. [DOI] [PubMed] [Google Scholar]
  11. Reasbeck P. G., Rice M. L., Herbison G. P. Nasogastric intubation after intestinal resection. Surg Gynecol Obstet. 1984 Apr;158(4):354–358. [PubMed] [Google Scholar]
  12. Woods J. H., Erickson L. W., Condon R. E., Schulte W. J., Sillin L. F. Postoperative ileus: a colonic problem? Surgery. 1978 Oct;84(4):527–533. [PubMed] [Google Scholar]

Articles from Annals of Surgery are provided here courtesy of Lippincott, Williams, and Wilkins

RESOURCES