Role of Routine Nasogastric Decompression After Subtotal Gastrectomy

Role of Routine Nasogastric Decompression After Subtotal Gastrectomy

The aim of the study is to evaluate whether subtotal gastrectomy without post-operative nasogastric decompression is better in terms of early post-operative bowel function and chest complication.

Nasogastric decompression is an intra-operative routine in most of the time to facilitate exposure of operative field during elective subtotal gastrectomy, but whether it should be retained post-operatively is controversial. Nasogastric decompression helps to drain the gastric remnant in case there is edema around the gastrojejunostomy, ileus and delayed gastric emptying, which can theoretically relieve nausea and abdominal distension. Besides, it may help decrease diaphragmatic splintage and hence decrease chance of chest infection if ileus occurs. However, nasogastric intubation could cause patient discomfort; also it has been shown that it would cause gastroesophageal reflux which may be associated with chest complication. There have been studies showing that routine post-operative nasogastric decompression is not necessary for gastrectomy in general, but the role in subtotal gastrectomy for stomach cancer is not well defined.

Inclusion Criteria:All patients suffering from carcinoma of stomach, decided for operation

• subtotal, D1/D2 dissection
• palliative resection

Exclusion Criteria:

• actively bleeding tumor
• perforation of tumor
• patient present with gastric outlet obstruction
• combine organ excision
• known diabetes with nephropathy