Nasojejunal tube placement after total gastrectomy - A multicenter prospective randomized trial

被引:51
作者
Doglietto, GB
Papa, V
Tortorelli, AP
Bossola, M
Covino, M
Pacelli, F
机构
[1] Catholic Univ, Sch Med, Dept Surg Sci, Digest Surg Unit, I-00135 Rome, Italy
[2] Catholic Univ, Sch Med, Dept Emergency Med, I-00135 Rome, Italy
关键词
D O I
10.1001/archsurg.139.12.1309
中图分类号
R61 [外科手术学];
学科分类号
摘要
Hypothesis: Anastomotic disruption of the Roux-en-Y esophagojejunostomy after total gastrectomy is an infrequent complication that may lead to severe morbidity and mortality. Consequently, a nasojejunal tube (NJT) is frequently placed when this operation is performed. However, no studies have compared routine vs no placement of an NJT in patients undergoing total gastrectomy for gastric cancer, to our knowledge. Design: Randomized controlled trial to assess the need for routine nasojejunal decompression after total gastrectomy with Roux-en-Y esophagojejunostomy in patients with gastric cancer. Setting: Tertiary care centers. Patients: Two hundred thirty-seven patients undergoing total gastrectomy for gastric cancer were randomly assigned to NJT placement (NJT group) or not (no-NJT group). The patients were monitored for postoperative complications, mortality, and postoperative course. Main Outcome Measures: incidence of esophagojejunostomy leak. Results: The rates of anastomotic leak were similar in both groups (6.9% and 5.8% for the NJT group and no-NJT group, respectively; P=.71), as were the rates of major postoperative complications (25.9% and 21.5%, respectively; P=.42) and overall postoperative mortality (0.9% and 0.8%, respectively; P=.50). There were no differences between the 2 groups in the mean+/-SD time to passage of flatus (4.6+/-1.3 and 4.5+/-1.7 days, respectively) or to starting a liquid diet (7.8+/-2.6 and 7.7+/-1.6 days, respectively), postoperative length of hospital stay (13.5+/-7.3 and 13.9+/-10.9 days, respectively), postoperative pain, or postoperative abdominal distention. Conclusion: Routine placement of an NJT after Rouxen-Y esophagojejunostomy is unnecessary in elective total gastrectomy for gastric cancer.
引用
收藏
页码:1309 / 1313
页数:5
相关论文
共 17 条
  • [1] IS ROUTINE USE OF THE NASOGASTRIC TUBE JUSTIFIED IN UPPER ABDOMINAL-SURGERY
    ARGOV, S
    GOLDSTEIN, I
    BARZILAI, A
    [J]. AMERICAN JOURNAL OF SURGERY, 1980, 139 (06) : 849 - 850
  • [2] Postoperative enteral versus parenteral nutrition in malnourished patients with gastrointestinal cancer: a randomised multicentre trial
    Bozzetti, F
    Braga, M
    Gianotti, L
    Gavazzi, C
    Mariani, L
    [J]. LANCET, 2001, 358 (9292) : 1487 - 1492
  • [3] Early complications following total gastrectomy for gastric cancer
    Budisin, N
    Budisin, E
    Golubovic, A
    [J]. JOURNAL OF SURGICAL ONCOLOGY, 2001, 77 (01) : 35 - 41
  • [4] PROPHYLACTIC POSTOPERATIVE NASOGASTRIC DECOMPRESSION - A PROSPECTIVE-STUDY OF ITS REQUIREMENT AND THE INFLUENCE OF CIMETIDINE IN 200 PATIENTS
    CHEADLE, WG
    VITALE, GC
    MACKIE, CR
    CUSCHIERI, A
    [J]. ANNALS OF SURGERY, 1985, 202 (03) : 361 - 366
  • [5] Pancreas-preserving total gastrectomy for gastric cancer
    Doglietto, GB
    Pacelli, F
    Caprino, P
    Bossola, M
    Di Stasi, C
    [J]. ARCHIVES OF SURGERY, 2000, 135 (01) : 89 - 92
  • [6] Protein-sparing therapy after major abdominal surgery - Lack of clinical effects
    Doglietto, GB
    Gallitelli, L
    Pacelli, F
    Bellantone, R
    Malerba, M
    Sgadari, A
    Crucitti, F
    Gaggiotti, G
    Carrata, R
    Lippolis, A
    Morgese, A
    Martino, D
    Lattarulo, V
    Margiotta, F
    DaRold, A
    Roversi, CA
    Fontana, A
    Nicodemo, P
    Leone, V
    Tonelli, P
    Bonera, A
    Alberti, P
    Zanni, F
    Scuderi, C
    Terranova, ML
    Braga, M
    Gianotti, L
    Galli, E
    Corti, T
    Maggioni, D
    Marzari, A
    Aseni, P
    Mercurio, A
    DeSiena, M
    Giombolini, A
    Annesi, L
    Lolli, A
    Pasquale, R
    DeSantis, L
    Casoni, P
    Botta, P
    Paolo, D
    Vassili, J
    Morelli, G
    Doglietto, JB
    Carriero, C
    Valentini, L
    Sasso, F
    DiPinto, A
    Gulino, G
    [J]. ANNALS OF SURGERY, 1996, 223 (04) : 357 - 362
  • [7] Assessment of routine elimination of postoperative nasogastric decompression after Roux-en-Y gastric bypass
    Huerta, S
    Arteaga, JR
    Sawicki, MP
    Liu, CD
    Livingston, EH
    [J]. SURGERY, 2002, 132 (05) : 844 - 848
  • [8] GALLBLADDER SLUDGE AND STONE FORMATION IN RELATION TO CONTRACTILE FUNCTION AFTER GASTRECTOMY - A PROSPECTIVE-STUDY
    INOUE, K
    FUCHIGAMI, A
    HIGASHIDE, S
    SUMI, S
    KOGIRE, M
    SUZUKI, T
    TOBE, T
    [J]. ANNALS OF SURGERY, 1992, 215 (01) : 19 - 26
  • [9] Jähne J, 2001, HEPATO-GASTROENTEROL, V48, P1222
  • [10] MACRAE HM, 1992, CAN J SURG, V35, P625