Omission of Nasogastric Tube Application in Postoperative Care of Esophagectomy

Abstract

INTRODUCTION: Surgeons routinely use nasogastric (NG) tubes in most esophageal resection surgeries. Considering the numerous complications caused by using the tube and the uncertainty about its usefulness and the scarcity of studies conducted on the subject, particularly in patients with esophageal cancer, the necessity of using the tube in these types of cases is investigated in the present study. METHODS: In this clinical trial, patients with esophageal cancer were randomized into groups with NG tube and without NG tube after surgery; the latter were prescribed metoclopramide, as well. The variables recorded for each patient included the first day of gas passage, defecation and bowel sounds (BSs) auscultation, as well as the duration of postoperative hospitalization, nausea and vomiting, abdominal distension, pulmonary complications, wound complications, anastomosis leak, and the need for placing/replacing the NG tube. RESULTS: The incidence of anastomosis leak was significantly higher in the NG-tube group (6 vs. 0; P=0.016). Other complications were not different in the two groups. The mean time of gas passage, defecation, BS auscultation, and the duration of postoperative hospitalization did not have meaningful differences in the two groups. The need for placing/replacing the NG tube was the same for both groups. CONCLUSIONS: The routine application of NG tubes after surgery is not recommended for all patients. We suggest that NG tubes should be used according to the specific problems of each patient.