Nasogastric decompression following elective colorectal surgery: a prospective randomized study

Abstract

A prospective, randomized study was conducted to determine the need for nasogastric decompression following elective colorectal surgery for malignant and premalignant lesions. Seventy-seven consecutive patients were randomly assigned to one of two groups: Group 1--nasogastric decompression was maintained postoperatively until resumption of bowel function; Group 2--the nasogastric tube was removed in the recovery room. Forty patients were assigned to Group 1 (21 males, 19 females) and 37 to Group 2 (22 males and 15 females). Eleven patients in Group 1 (28%) developed nausea postoperatively, with six patients (15%) having an average of less than two emeses and five (12%) requiring nasogastric reintubation. Thirteen patients in Group 2 (35%) developed nausea, with 10 patients (27%) having an average of two emeses and three (8%) requiring nasogastric intubation (P = 0.80). Abdominal distention was observed in 13 patients (32%) in both Group 1 (32%) and Group 2 (35%). Two of the latter patients required nasogastric reintubation. Postoperative fever was noted in 23 patients (58%) in Group 1 and 14 (38%) in Group 2 (P = 0.13); atelectasis was diagnosed in 38 per cent of patients in Group 1 and 14 per cent in Group 2 (P = 0.03). These data support that nasogastric decompression is not necessary following elective colorectal surgery for malignant and premalignant lesions.