Chung Ho Young, Yu Wansik
Department of Surgery, School of Medicine, Kyungpook National University, Taegu, Korea.
Hepatogastroenterology. 2003 Jul-Aug;50(52):1190-2.
BACKGROUND/AIMS: We reviewed postoperative courses of patients with gastric cancer who underwent gastrectomy to evaluate the need for routine postoperative gastrointestinal decompression.
Three hundred patients who underwent gastrectomy during 1998 and 1999 were enrolled in this study. A nasogastric tube was placed in all patients just after induction of the anesthesia. The patients were divided into two groups, 150 patients for each. In group 1, the nasogastric tube was maintained until the passage of flatus per rectum. In group 2, the nasogastric tube was removed immediately after the operation.
The return of bowel function, return to a diet and postoperative length of hospital stay were similar in both groups. In group 1, only one patient (0.7%) had abdominal distension and no patient vomited, while four patients (2.7%) had abdominal distension and one patient (0.7%) vomited in group 2. There were no significant differences in the incidence of respiratory complications, anastomotic leakage and wound complications between the two groups. Postoperative death was rare, with the incidence of 0.7% in each group. There was a significantly high incidence of patient's discomfort in group 1. The major complaint was sore throat and it caused sleep disturbance when severe.
It is desirable to insert a nasogastric tube while the patient is in the anesthetized state and keep it during operation and remove it immediately after operation, when no active bleeding is detected.
背景/目的：我们回顾了接受胃切除术的胃癌患者的术后病程，以评估术后常规胃肠减压的必要性。
本研究纳入了1998年至1999年期间接受胃切除术的300例患者。所有患者在麻醉诱导后立即放置鼻胃管。患者被分为两组，每组150例。在第1组中，鼻胃管保留至直肠排气。在第2组中，术后立即拔除鼻胃管。
两组患者的肠功能恢复、恢复饮食情况及术后住院时间相似。在第1组中，只有1例患者（0.7%）出现腹胀，无患者呕吐；而在第2组中，有4例患者（2.7%）出现腹胀，1例患者（0.7%）呕吐。两组患者在呼吸并发症、吻合口漏及伤口并发症的发生率方面无显著差异。术后死亡罕见，每组发生率均为0.7%。第1组患者不适的发生率显著较高。主要抱怨是喉咙痛，严重时会导致睡眠障碍。
理想的做法是在患者处于麻醉状态时插入鼻胃管，并在手术期间保留，在未发现活动性出血时术后立即拔除。
