Huerta Sergio, Arteaga James R, Sawicki Mark P, Liu Carson D, Livingston Edward H
VAMC Greater Los Angeles Health Care System, the UCLA Bariatric Surgery Program, and the UCLA Center for Human Nutrition, Los Angeles, CA 90095, USA.
Surgery. 2002 Nov;132(5):844-8. doi: 10.1067/msy.2002.127678.
Anastomotic disruption after surgical intervention is an infrequent complication, but may lead to severe morbidity and mortality when it occurs. Of the various gastric procedures, the Roux-en-Y gastric bypass (RYGB) has one of the highest risks for anastomotic leakage. Consequently, a nasogastric tube (NGT) is frequently placed when these operations are performed. Most studies examining the outcomes for patients without postoperative NGTs have been relatively small with groups of patients undergoing a variety of operations. Assessing the incidence of anastomotic leaks by routine elimination of postoperative NGTs requires a large number of patients. In this study, we assessed the safety and efficacy of routine elimination of NGTs in a large cohort of patients undergoing a single operation.
We reviewed our experience with 1067 patients who underwent RYGB at the UCLA medical center. Fifty-six patients had NGTs routinely placed before the implementation of a standard protocol, which eliminated postoperative NGT decompression. The complication rate for the RYGB patient cohort with and without postoperative NGT was compared.
We found no difference in the complication rates between the 2 groups (Fisher exact test; P =.21).
Our findings suggest that routine placement of an NGT after RYGB is unnecessary.
手术干预后吻合口破裂是一种罕见的并发症，但一旦发生可能导致严重的发病率和死亡率。在各种胃部手术中，Roux-en-Y胃旁路术（RYGB）发生吻合口漏的风险最高。因此，在进行这些手术时经常放置鼻胃管（NGT）。大多数研究未放置术后NGT的患者结局，这些研究规模相对较小，且患者群体接受了各种手术。通过常规排除术后NGT来评估吻合口漏的发生率需要大量患者。在本研究中，我们评估了在一大群接受单一手术的患者中常规排除NGT的安全性和有效性。
我们回顾了在加州大学洛杉矶分校医学中心接受RYGB手术的1067例患者的经验。在实施一项标准方案之前，有56例患者常规放置了NGT，该方案取消了术后NGT减压。比较了有和没有术后NGT的RYGB患者队列的并发症发生率。
我们发现两组之间的并发症发生率没有差异（Fisher精确检验；P = 0.21）。
我们的研究结果表明，RYGB术后常规放置NGT是不必要的。
