A comparative study evaluating the role of nasogastric tube following ileostomy reversal surgery

Abstract

Abstract Background: Nasogastric tube (NT) is commonly used following abdominal surgeries with a belief that it will decompress the bowel and prevent complications such as abdominal distension and post-operative nausea and vomiting. However, many studies have now reported that the use of a NT after abdominal surgery is not only unnecessary but also can be harmful to the patient. Methods: This was a prospective and interventional randomised comparative study where patients undergoing elective ileostomy reversal (n = 120) were randomly divided into two groups: patients with (Group A), and without (Group B) the placement of the NT in the post-operative period (n = 60 each). Post-operative parameters like time to pass first flatus and stool, the first appearance of bowel sounds, length of hospital stay, post-operative hospital stay, post-operative complications such as pneumonia, fascial dehiscence, anastomotic leak, nausea, vomiting and need for tube insertion/reinsertion were recorded. Results: Mean time (post-operative days) for appearance of first bowel sounds (P < 0.0001), passing first flatus (P < 0.0001) and first stool (P < 0.0001) were significantly higher in Group A as compared to Group B (P < 0.0001). The mean duration of hospital stay (days) was also significantly higher in Group A compared to Group B (8.8 ± 1.5 Vs 5.5 ± 1). The proportion of patients who developed a chest infection in both Groups A and B was comparable. Conclusions: Use of a NT during the post-operative period after ileostomy reversal surgery does not provide any additional benefit and may be harmful in terms of early patient recovery.