Nasogastric intubation after intestinal resection

Abstract

Despite some evidence that gastric decompression may be unnecessary after some abdominal operations and in the treatment of paralytic ileus, the use of nasogastric suction after extensive abdominal operations, particularly intestinal resection, remains a subject of some debate. In a randomized prospective trial, 52 patients with suture lines constructed in the gastrointestinal tract received no postoperative nasogastric drainage unless acute gastric dilation or copious vomiting developed postoperatively, while 45 similar patients were allocated to receive routine postoperative nasogastric aspiration. Only 12 patients in the nonintubated group required subsequent insertion of a nasogastric tube, while in the remaining 40, nasogastric drainage was avoided completely. Postoperative loss of fluid from the intestine was significantly greater in the patients undergoing routine nasogastric drainage, although the requirement for intravenous fluid therapy was the same in both groups. There were no significant differences between the two groups in the incidence of postoperative complications. Routine nasogastric aspiration after gastric or intestinal resection does not confer significant advantages to outweigh its discomfort and potential morbidity for patients and should be replaced by selective intubation when required postoperatively.