Pan Huaguang, Yu Zaicheng, Zhang Renquan, Kang Ningning, Che Yun, Ge Wei, Zhang Wei, Hu Xu
Department of Thoracic Surgery, The First Affiliated Hospital, Anhui Medical University, Hefei 230022, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2014 Sep;17(9):920-3.
To investigate the safety and feasibility of forgoing postoperative nasogastric tube decompression in minimally invasive esophagectomy for patients with esophagus carcinoma.
Clinical data of 90 eligible patients who underwent elective minimally invasive esophagectomy in our department from January 2012 to May 2013 by the same surgical team were retrospectively analyzed. Among them, 45 patients did not receive the use of postoperative nasogastric tube decompression and 45 patients received nasogastric tube decompression after operation. The observation parameters included the time to first flatus, the time to intake of fluid diet, the duration of postoperative hospitalization, pharyngalgia, vomiting, and postoperative complications, as well as the need for placing or replacing the nasogastric tube.
The incidence of pharyngalgia was significantly higher in nasogastric tube group (100% vs 44.4%, P<0.001). The time to intake of fluid diet [median 2 d(2-4 d) vs. median 9 d(7-20 d), P<0.001] and the time to first flatus [median 3 d(3-8 d) vs. median 6 d(3-9 d), P<0.001] were all significantly shorter in non-nasogastric tube group as compared to nasogastric tube group. Compared with the nasogastric tube group, the non-nasogastric tube group had shorter postoperative hospital stay (P<0.001). There were no significant differences in the incidence of postoperative complications and vomiting between two groups.
Minimally invasive esophagectomy without the use of postoperative nasogastric tube decompression is safe and feasible, which can improve recovery and shorten postoperative hospital stay.
探讨食管癌患者在微创食管切除术中不进行术后鼻胃管减压的安全性和可行性。
回顾性分析2012年1月至2013年5月在我科由同一手术团队进行择期微创食管切除术的90例符合条件患者的临床资料。其中，45例患者未接受术后鼻胃管减压，45例患者术后接受鼻胃管减压。观察指标包括首次排气时间、流食摄入时间、术后住院时间、咽痛、呕吐、术后并发症以及放置或更换鼻胃管的必要性。
鼻胃管组咽痛发生率显著高于非鼻胃管组（100%对44.4%，P<0.001）。与鼻胃管组相比，非鼻胃管组流食摄入时间[中位数2天（2 - 4天）对中位数9天（7 - 20天），P<0.001]和首次排气时间[中位数3天（3 - 8天）对中位数6天（3 - 9天），P<0.001]均显著缩短。与鼻胃管组相比，非鼻胃管组术后住院时间更短（P<0.001）。两组术后并发症发生率和呕吐发生率无显著差异。
微创食管切除术不使用术后鼻胃管减压是安全可行的，可促进恢复并缩短术后住院时间。
