Systematic Evaluation of Preemptive Nasogastric Decompression Following Abdominal Surgeries

Background: Routine use of nasogastric tubes (NGTs) after abdominal surgeries aims to reduce anastomotic leakage risk, avoid pulmonary consequences, and shorten hospital stays while also promoting patient comfort. The effectiveness of this approach following abdominal surgery in accomplishing each of these aims is investigated in this meta-analysis of published trials. Method: The Cochrane Controlled Trials Register, Medline search, Embase, and references from included studies were used in the search. The search terms were "randomised, nasogastric tubes," etc. Patients undergoing abdominal surgeries of any kind, whether emergency or elective, who were randomly assigned before the operation to receive a nasogastric tube and keep it in place until intestinal function had returned or to selective use of a tube with early removal were included in the studies that qualified. Results: 21 studies met the qualifying requirements. These patients totaled 3034, with 1466 receiving a selective or no tube and 2108 receiving a regular tube. Those who did not usually receive a nasogastric tube had an earlier recovery of bowel function (P more than 0.001), a slight reduction in pulmonary problems (P=0.07), and slight increases in wound infection and ventral hernia (P=0.075 and P=0.085, respectively). Anastomotic leakage was comparable between the two groups (P=0.70). In conclusion: routine nasogastric decompression should be replaced with selective nasogastric tube use because it does not achieve any of its claimed purposes.