Is Routine Nasogastric Intubation Necessary for Elective Colorectal Surgery?: a Prospective Randomized Controlled Trial

ABSTRACT

PURPOSE: This study was performed to assess the complications and discomfort of patients with or without a nasogastric tube who underwent elective colorectal surgery and to evaluate the efficacy of the routine practice of employing a nasogastric tube after elective colorectal surgery. METHODS: This study involved a prospective, randomized trial of 100 patients undergoing elective colorectal surgery from February to July 2004. The patients were classified as the nasogastric tube inserted group (NG (+), n=50) and non-inserted group (NG (-), n=50). The inclusion criteria were elective colorectal surgery, age under 70 years and no previous abdominal surgery history. The exclusion criteria were an emergent operation, an overt preoperative bowel obstruction and extensive operations such as pouch surgery and multivisceral resection. RESULTS: The mean age of the subjects was 55 (24~70) years old. There was no difference in terms of age, gender, pathological diagnosis and surgical procedures between the NG (-) and NG (+) groups. A sore throat and nausea was more prevalent in the NG (+) group (P=0.000, P=0.046). The gas passage time was shorter in the NG (-) group than in the NG (+) group (P=0.028). The other variables, such as vomiting, postoperative ileus, postoperative fever, posto-perative atelectasis, postoperative leakage, intraoperativedecompression, stool passage time and the length of the hospital stay revealed no difference between the groups. CONCLUSION: Nasogastric intubation is an uncomfortable procedure for patients and offers no benefit in preventing postoperatve complications. The routine use of a nasogastric tube is not necessary in elective colorectal surgery.