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Inicio Cirugía Española (English Edition) Nasogastric tube utilization after esophagectomy: An unnecessary gesture?
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Vol. 98. Issue 10.
Pages 598-604 (December 2020)
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Vol. 98. Issue 10.
Pages 598-604 (December 2020)
Original article
DOI: 10.1016/j.cireng.2020.11.011
Nasogastric tube utilization after esophagectomy: An unnecessary gesture?
Uso de sonda nasogástrica en pacientes sometidos a esofaguectomía: ¿Un gesto innecesario?
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M. Menéndez-Jiméneza, M. Bruna-Estebana,
Corresponding author
drbruna@comv.es

Corresponding author.
, F. Mingola, J. Vaquéa, D. Hervásb, E. Álvarez-Sarradoa, M. Navasquillo-Tamarita, L. Hurtado-Pardoa, E. García-Graneroa
a Servicio de Cirugía General y del Aparato Digestivo. Hospital Universitario y Politécnico La Fe, Valencia, Spain
b Instituto de Investigación Sanitaria La Fe, Valencia, Spain
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Tables (4)
Table 1. Descriptive Study of patient characteristics.
Table 2. Characteristics of the surgery and postoperative course.
Table 3. Postoperative morbidity, mortality and rate of readmission.
Table 4. Estimation of the risk for postoperative complications associated with the use of NGT.
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Additional material (1)
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Abstract
Introduction

Nasogastric decompressive tube utilization has been accepted as one of the basic perioperative care measures after esophageal resection surgery. However, with the development of multimodal rehabilitation programs and without clear evidence to support their use, the systematic indication of this measure may be controversial.

Material and methods

Retrospective, descriptive and comparative study of patients who had undergone Ivor-Lewis esophagectomy in our center – from January 2015 to December 2018 – with placement (Group S), or without placement (Group N) of a decompressive tube in gastroplasty during postoperative period. Epidemiological variables and differences between groups in post-surgical morbidity and mortality, hospital stay, onset of oral tolerance and the need for nasogastric tube placement were evaluated.

Results

A total of 43 patients were included in this study, with a median age of 61 years, being 86% male. 46.5% were hypertensive, 25.5% had lung disease and 16.3% had diabetes mellitus. The median length of hospital stay was 9 days in group S versus 11.5 days in group N, with no differences in the onset of oral tolerance. Anastomotic dehiscence rate was 5% and 0% respectively. The overall mortality was 2.3% in the first 90 days, without differences between the groups. Placement of nasogastric tube during postoperative period was required only in 1 patient (4.3%) of the group N.

Conclusions

Non-use of nasogastric tube during postoperative period of an Ivor-Lewis esophagectomy is a safe measure, as it is not associated with a higher rate of complications or hospital stay. This fact may be able to improve patients’ comfort and postoperative recovery.

Keywords:
Nasogastric tube
Esophagectomy
Enhanced recovery after surgery
Resumen
Introducción

El empleo de una sonda descompresiva nasogástrica es aceptado como uno de los cuidados perioperatorios básicos tras una cirugía de resección esofágica. Sin embargo, con el desarrollo de los programas de rehabilitación multimodal en este campo y sin una evidencia clara que sustente su empleo, la indicación sistemática de dicha medida puede resultar controvertida.

Material y métodos

Estudio retrospectivo, descriptivo y comparativo de los casos intervenidos de esofaguectomía tipo Ivor-Lewis en nuestro centro desde enero de 2015 hasta diciembre de 2018 con colocación (Grupo S) o no de sonda (Grupo N) descompresiva en la plastia gástrica durante el postoperatorio. Se evaluaron variables epidemiológicas y diferencias entre los grupos en morbimortalidad postquirúrgica, estancia hospitalaria, inicio de la tolerancia oral y la necesidad de colocación de sonda nasogástrica.

Resultados

Un total de 43 pacientes fueron incluidos en este estudio con una mediana de edad de 61 años, siendo el 86% varones. El 46,5% eran hipertensos, el 25,5% presentaban enfermedad pulmonar y el 16,3% padecían diabetes mellitus. La mediana del tiempo de estancia hospitalaria fue de nueve días en el grupo S frente a 11,5 días del grupo N, sin diferencias en el inicio de la tolerancia oral. La tasa de dehiscencia anastomótica fue del 5% y del 0%, respectivamente. La mortalidad global fue del 2,3% en los primeros 90 días, sin diferencias entre los grupos y la necesidad de colocación de la sonda durante el postoperatorio se produjo únicamente en un paciente (4,3%) del grupo N.

Conclusiones

La no utilización de sonda nasogástrica durante el postoperatorio de una esofaguectomía tipo Ivor-Lewis es una medida segura y no está asociada a mayor número de complicaciones ni estancia hospitalaria, pudiendo mejorar la comodidad y la recuperación postoperatoria del paciente.

Palabras clave:
Sonda nasogástrica
Esofaguectomía
Rehabilitación multimodal

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