Department of Surgery, Shanghai Institute of Digestive Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Dig Surg. 2011;28(3):167-72. doi: 10.1159/000323744. Epub 2011 May 4.
The purpose of this study was to evaluate the necessity of a nasogastric decompression in radical gastrectomy for gastric cancer patients by a prospective randomized controlled trial.
From 2007 to 2009, 161 gastric cancer patients who underwent radical gastrectomy were randomly selected and entered into three groups: tube group (TG), intra-operative tube group (ITG), and no-tube group (NTG). The variables studied among the groups were demographic characteristics, surgical characteristics, postoperative recovery and complications.
With respect to demographic and surgical characteristics, there were no significant differences among the 3 groups. The time of the first passage of flatus, tolerance of water intake, liquid diet and semiliquid diet were similar among TG, ITG and NTG. Postoperative hospital stay was increased in patients from TG compared to NTG (11.3 vs. 10.2 days, p = 0.031). The incidence of nausea was significantly higher in TG than in ITG or NTG (64 vs. 36.8 and 29.6%). The overall postoperative complication rate was not significantly different among these groups (20, 15.8 and 20.4% in TG, ITG and NTG, respectively, p = 0.612).
Radical gastrectomy can be performed safely without nasogastric decompression for gastric cancer patients. The routine prophylactic nasogastric decompression is unnecessary.
本研究旨在通过前瞻性随机对照试验评估胃癌根治术中行胃肠减压的必要性。
2007 年至 2009 年，随机选择 161 例胃癌根治术患者，分为管组（TG）、术中管组（ITG）和无管组（NTG）。研究各组的变量包括人口统计学特征、手术特征、术后恢复和并发症。
在人口统计学和手术特征方面，三组间无显著差异。TG、ITG 和 NTG 组患者的首次排气时间、饮水耐受时间、液体饮食和半液体饮食时间相似。与 NTG 组相比，TG 组患者的术后住院时间延长（11.3 天 vs. 10.2 天，p=0.031）。TG 组恶心的发生率明显高于 ITG 组或 NTG 组（64%比 36.8%和 29.6%）。三组术后总体并发症发生率无显著差异（TG、ITG 和 NTG 组分别为 20%、15.8%和 20.4%，p=0.612）。
胃癌根治术可安全进行，无需胃肠减压。常规预防性胃肠减压是不必要的。
