A Guideline on the Removal Time of the Nasogastric Tube Following Gastrectomy

PURPOSE: There is no standard principle as to the nasogastric tube decompression period following gastrectomy. This prospective randomized study was done in an attempt to define the affect of the nasogastric tube decompression period on the postoperative course with a special reference to early postoperative complications, gas passing time, and the length of hospital stay after gastrectomy. METHODS: We reviewed 201 patients among 402 cases who had received gastrectomy because of gastric cancer. The patients were classified as those whose tubes were removed within 48 hours postoperatively, and those whose tubes remained for more than 48 hours (early group: n=70, late group: n=131). RESULTS: No significant differences were noted in regards to complication rate, or hospital stay. However, a significant decrease in the time to first gas passing was noted in the early removal group compared to late group (4.13+/-1.33 day vs. 4.39+/-1.50 day, P=0.040). CONCLUSION: These results indicate that the early removal of the nasogastric tube following gastrectomy is safely recommended in order to reduce patient discomfort.

A Porcine Model for Non-heart Beating Donor Liver Transplantation / 대한이식학회지

PURPOSE: Non-heart-beating liver transplantation has been accepted as a substitute to overcome the donor shortage problem. However, prolonged warm ischemia during liver procurement remains a obstacle to widespread use of non- heart-beating transplantation. Therefore, experimental studies to ameliorate graft injuries have been conducted, but, their clinical applications are not satisfactory yet. The aim of this study is to test our experimental model as a pertinent non- heart-beating transplantation model. METHODS: We designed porcine non-heart-beating liver transplantation model by simultaneous liver procurement of donor and recipient. Cardiac death was induced by direct cardiac injection of potassium chloride. Perfusion of normothermic hypertonic saline started after 30-min (group A, N=5), 1-hour (group B, N=4). Orthotopic liver transplantation with perfused donor liver was performed and we compared the perioperative laboratory parameter, histologic findings and survival between two groups. RESULTS: Only one (11.1%) death occurred among the nine transplant pigs. 2-day survival rates of group A and B were 60%, 50%, respectively. Group A showed a relatively acceptable posttransplant laboratory findings including liver function test and normal-looking histologic feature at the time of reperfusion and 24 hours after reperfusion. Group B showed more deranged liver function test and ischemic liver cell morphology at 24 hours after reperfusion. CONCLUSION: Our results suggest that this porcine non-heart-beating transplantation model may be the safe and suitable method. This model will be useful in further study for testing the perfusate and drugs to ameliorate the warm ischemia-induced hepatic injury.