Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
European Journal of Trauma and Emergency Surgery
Published in: European Journal of Trauma and Emergency Surgery 1/2022

01-02-2022 | Ileus | Original Article

Nasogastric tube after small bowel obstruction surgery could be avoided: a retrospective cohort study

Authors: Maxime Delestre, Pierre Berge, Christophe Aubé, Antoine Hamy, Jean-François Hamel, Anita Paisant, Aurélien Venara

Published in: European Journal of Trauma and Emergency Surgery | Issue 1/2022

Login to get access

Abstract

Purpose

The safety and feasibility of early removal of nasogastric tube (NGT) after small bowel obstruction (SBO) surgery have not yet been assessed. Such a practice could allow to implement enhanced recovery after surgery (ERAS) protocols after acute SBO surgery. The aims of this study were to assess the safety of early NGT removal by comparing the short-term outcomes of patients with postoperative NGTs and those with no postoperative NGT.

Methods

All patients undergoing surgery for strangulation or adhesive SBO between January the 1st of 2014 and December the 31st of 2017 were retrospectively included.

Results

Among the 123 included, NGT was removed immediately after the end of the procedure in 26 cases (21.1%) and 19 patients required NGT replacement (15.4%). In univariate analysis, early removal of NGT was significantly associated with a reduction of overall morbidity, severe morbidity and postoperative ileus occurrence.
Multivariate analysis confirmed that NGT left in place was a risk factor for postoperative ileus [Odd Ratio (OR) 4.9, Confidence Interval (CI) 95% 1.3–19.2; p = 0.02], while it has no incidence on severe morbidity.

Conclusions

Early NGT removal after ASBO surgery seemed to be feasible, safe and efficient, at least in selected patients. This primary study represents the initial foundations for building the implementation of ERAS protocols after ASBO surgery.
Literature
1.
Hajibandeh S, Hajibandeh S, Bill V, Satyadas T. Metaanalysis of enhanced recovery after surgery (ERAS) protocols in emergency abdominal surgery. World J Surg. 2020;44:1336–448.CrossRefPubMed
2.
Shida D, Tagawa K, Inada K, et al. Modified enhanced recovery after surgery (ERAS) protocols for patients with obstructive colorectal cancer. BMC Surg. 2017;17:18.CrossRefPubMedPubMedCentral
3.
Shang Y, Guo C, Zhang D. Modified enhanced recovery after surgery protocols are beneficial for postoperative recovery for patients undergoing emergency surgery for obstructive colorectal cancer: a propensity score matching analysis. Medicine (Baltimore). 2018;97:e12348.CrossRef
4.
5.
Ten Broek RPG, Krielen P, Di Saverio S, Ansaloni L, Velmahos GC, Sartelli M, et al. Bologna guidelines for diagnosis and management of adhesive small bowel obstruction (ASBO): 2017 update of the evidence-based guidelines from the world society of emergency surgery ASBO working group. World J Emerg Surg. 2018;13:24.CrossRefPubMedPubMedCentral
6.
Rondenet C, Millet I, Corno L, Boulay-Coletta I, Taourel P, Zins M. Increased bowel-wall attenuation: a specific sign of bowel necrosis in closed-loop small-bowel obstruction. Eur Radiol. 2018;28:4228–33.CrossRef
7.
Venara A, Barbieux J, Colas PA, Le Fouler A, Lermite E, Hamy A. Primary surgery for malignant large bowel obstruction: postoperative nasogastric tube reinsertion is not mandatory. World J Surg. 2017;41:1903–9.CrossRefPubMed
8.
Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240:205–13.CrossRefPubMedPubMedCentral
9.
Ludwig K, Enker WE, Delanay CP, Wolff BG, Du W, Fort JG, et al. Gastrointestinal tract recovery in patients undergoing bowel resection: results of a randomized trial of alvimopan and placebo with a standardized accelerated postoperative care pathway. Arch Surg. 2008;143:1098–105.CrossRefPubMed
10.
Vather R, Trivedi S, Bissett I. Defining postoperative ileus: results of a systematic review and global survey. J Gastrointest Surg. 2013;17:962–72.CrossRefPubMed
11.
Markogiannakis H, Messaris E, Dardamanis D, Pararas N, Tzertzemzlis D, Giannopoulos P. Acute mechanical bowel obstruction: clinical presentation, etiology, management and outcomes. World J Gastroenterol. 2007;13:432–7.CrossRefPubMedPubMedCentral
12.
Fonseca AL, Schuster KM, Maung AA, Kaplan LJ, Davis KA. Routine nasogastric tube decompression in small bowel obstruction: is it really necessary? Am Surg. 2013;79:422–8.CrossRefPubMed
13.
Berman DJ, Ijaz H, Alkhunaizi M, Kulie PE, Vaziri K, Richards LM, et al. Nasogastric decompression not associated with a reduction in surgery or bowel ischemia for acute small bowel obstruction. Am J Emerg Med. 2017;35:1919–21.CrossRefPubMed
14.
Sapkota R, Bhandari RS. Prophylactic nasogastric decompression after emergency laparotomy. JNMA J Nepal Med Assoc. 2013;52:437–42.PubMed
15.
16.
Rees J, Bobridge K, Cash C, Lyons-Wall P, Allan R, Coombes J. Delayed postoperative diet is associated with a greater incidence of prolonged postoperative ileus and longer stay in hospital for patients undergoing gastrointestinal surgery. Nutr Diet. 2018;75:24–9.CrossRefPubMed
17.
Short V, Herbert G, Perry R, et al. Chewing gum for postoperative recovery of gastrointestinal function. Cochrane database syst rev. 2015;20:CD0065006.
18.
Byrne J, Saleh F, Ambrosini L, Quereshy F, Jackson TD, Okrainec A. Laparoscopic versus open surgical management of adhesive small bowel obstruction: a comparison of outcomes. Surg Endosc. 2015;29:2525–32.CrossRefPubMed
19.
Sebastian-Valverde E, Poves I, Membrillar-Fernandez E, Pons-Fragero MJ, Grande L. The role of the laparoscopic approach in the surgical management of acute adhesive small bowel obstruction. BMC Surg. 2019;19:40.CrossRefPubMedPubMedCentral
20.
Sapci I, Hameed I, Ceylan A, et al. Predictors of ileus following colorectal resections. Am J Surg. 2020;219:527–9.CrossRefPubMed
21.
Sindell S, Causey MW, Bradley T, Poss M, Moonka R, Thirlby R. Expediting return of bowel function after colorectal surgery. Am J Surg. 2012;203:644–8.CrossRefPubMed
22.
Gustafsson UO, Scott MJ, Hubner M, Nygren J, Demartines N, Francis N, et al. Guidelines for perioperative care in elective colorectal surgery: enhanced recovery after surgery (ERAS®) Society recommendations: 2018. World J Surg. 2019;43:659–95.CrossRefPubMed
23.
Wisely JC, Barclay KL. Effects of an enhanced recovery after surgery programme on emergency surgical patients. ANZ J Surg. 2016;86:883–8.CrossRefPubMed
24.
Hernandez MC, Birindelli A, Bruce JL, Buitendag JJP, Kong VY, Beuran M, et al. Application of the AAST EGS Grade for adhesive small bowel obstruction to a multi-national patient population. World J Surg. 2018;42:3785–91.CrossRefPubMed
25.
Venara A, Neunlist M, Slim K, Barbieux J, Colas PA, Hamy A, et al. Postoperative ileus: pathophysiology, incidence and prevention. J Visc Surg. 2016;153:439–46.CrossRefPubMed
Metadata
Title
Nasogastric tube after small bowel obstruction surgery could be avoided: a retrospective cohort study
Authors
Maxime Delestre
Pierre Berge
Christophe Aubé
Antoine Hamy
Jean-François Hamel
Anita Paisant
Aurélien Venara
Publication date
01-02-2022
Publisher
Springer Berlin Heidelberg
Keyword
Ileus
Published in
European Journal of Trauma and Emergency Surgery / Issue 1/2022
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI
https://doi.org/10.1007/s00068-020-01529-4

Other articles of this Issue 1/2022

European Journal of Trauma and Emergency Surgery 1/2022 Go to the issue

Original Article

Characteristics of pediatric thoracic trauma: in view of before and after the establishment of a regional trauma center

Original Article

Peri-implant femoral fractures in hip fracture patients treated with osteosynthesis: a retrospective cohort study of 1965 patients

Original Article

Geriatric polytrauma patients should not be excluded from aggressive injury treatment based on age alone

Editorial

Focus on emergency general surgery

Original Article

Evaluation of the altitude impact on a point-of-care thromboelastography analyzer measurement: prerequisites for use in airborne medical evacuation courses

Original Article

Variation in management of pediatric post-traumatic urine leaks