Clinical significance of nasointestinal tube placement in facilitating recovery after Roux-en-Y gastric bypass surgery / 中华临床营养杂志

ABSTRACT

Objective To investigate the clinical significance of nasointestinal tube placement in facilitating recovery after Roux-en-Y gastric bypass surgery.Methods The clinical data of patients with gastric neoplasms who underwent Roux-en-Y gastric bypass surgery were analyzed retrospectively.28 patients who had nasointestinal tube inserted were compared to 33 patients who didn't.Indicators for nutrition [body mass index (BMI),Nutrition Risk Screening 2002 (NRS 2002) score,serum total protein (TP),albumin (Alb) and prealbumin] and prognosis (bowel sound and anal exhaust or defecation time,anastomotic leakage rate,abdominal abscess or infection,incision infection or delayed healing,postoperative pulmonary infection rate,postoperative hospitalization time,unplanned reoperation or readmission rate) were analyzed.Results There was no statistically significant difference (all P＞0.05) between the two groups at baseline (sex,age,BMI,NRS 2002 score,operation time and blood loss during operation).The two groups had no statistically significant difference (all P＞0.05) in TP,Alb and prealbumin before the operation or at day 2 or day 6 after the operation.There were significant difference between the two groups in partial indicators for nutrition and prognosisprealbumin at sixth days after operation (t =-2.05,P =0.045),bowel sound (t =7.71,P =0.000),anal exhaust or defecation time (t=4.52,P=0.000),postoperative hospitalization time (t=4.43,P=0.000),incision infection or delayed healing rate (x2 =4.78,P =0.029).No statistically significant difference (all P＞ 0.05) was found in anastomotic leakage rate,abdominal abscess or infection rate,postoperative pulmonary infection rate,and unplanned reoperation and readmission rate (x2=1.94,P=0.164).There was significant difference (Fisher,P =0.029) between patients aged 70 or above in the two groups in terms of postoperative pulmonary infection rate.Conclusions Enteral nutrition via nasointestinal tube after Roux-en-Y operation in patients with gastric neoplasms can promote protein synthesis,facilitate recovery of intestinal function,shorten hospitalization time and accelerate patient recovery.However,extra caution is needed in patients aged 70 or above,and early extubation should be considered based on the lung conditions of these patients.