Nasogastric- vs. percutaneous gastrostomy tube for prophylactic gastric decompression after cytoreductive surgery with hyperthermic intraperitoneal chemotherapy
Author:
van Kooten Job P.1ORCID, de Boer Nadine L.1, Diepeveen Marjolein1, Verhoef Cornelis1, Burger Jacobus W. A.12, Brandt-Kerkhof Alexandra R. M.1, Madsen Eva V. E.1
Affiliation:
1. Department of Surgical Oncology and Gastrointestinal Surgery , Erasmus MC Cancer Institute , Rotterdam , The Netherlands 2. Department of Surgery , Catharina Hospital Cancer Institute , Eindhoven , The Netherlands
Abstract
Abstract
Objectives
Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) is associated with postoperative gastroparesis and ileus. In 2015, our practice shifted from using percutaneous gastrostomy tubes (PGT), to nasogastric tubes (NGT) for prophylactic gastric decompression after CRS-HIPEC. This study aimed to compare these methods for length of stay (LOS) and associated complications.
Methods
Patients that underwent CRS-HIPEC for peritoneal metastases from colorectal cancer between 2014 and 2019 were included. Cases were grouped based on receiving NGT or PGT postoperatively. Multivariable linear regression determined the independent effect of decompression method on LOS, thereby adjusting for confounders.
Results
In total, 179 patients were included in the analyses. Median age was 64 years [IQR:54–71]. Altogether, 135 (75.4%) received a NGT and 44 (24.6%) received a PGT. Gastroparesis occurred significantly more often in the PGT group (18.2 vs. 7.4%, p=0.039). Median LOS was significantly shorter for patients with a NGT (15 [IQR:12–19] vs. 18.5 [IQR:17–25.5], p<0.001). PGT was independently associated with longer LOS in multivariable analysis (Beta=4.224 [95%CI 1.243–7.204]). There was no difference regarding aspiration, pneumonia and postoperative mortality between groups.
Conclusions
NGT should be preferred over PGT for gastric decompression after CRS-HIPEC as it is associated with fewer gastroparesis and shorter LOS.
Publisher
Walter de Gruyter GmbH
Subject
Internal Medicine
Reference31 articles.
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