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World J Gastroenterol. 2012 Jan 21;18(3):251-6. doi: 10.3748/wjg.v18.i3.251.

Roux-en-Y reconstruction does not require gastric decompression after radical distal gastrectomy.

Author information

1
Division of General Surgery, Tri-Service General Hospital, National Defense Medical Center, 11490 Taipei, Taiwan, China.

Abstract

AIM:

To determine whether routine nasogastric (NG) decompression benefitted patients undergoing radical gastric surgery.

METHODS:

Between January 1998 and December 2008, 519 patients who underwent distal gastrectomy for gastric cancer were retrospectively divided into 2 time-period cohorts; those treated with Billroth II (BII) reconstruction in the first 6 years and those with Roux-en-Y (RY) reconstruction in the last 5 years. In the latter group, the patients were further divided into 2 subgroups; with and without nasogastric decompression.

RESULTS:

Postoperatively, there were no significant differences in the number of anastomotic leaks between the 3 groups. In the tubeless RY group, time to semi-liquid diet was significantly shorter than in the other 2 groups (4.4 d ± 1.4 d vs 7.2 d ± 1.3 d and 5.9 d ± 1.2 d, P = 0.005). The length of postoperative stay was significantly increased in patients with BII reconstruction compared with patients with RY reconstruction with/without NG decompression (15.4 d ± 4.3 d in BIIgroup vs 12.6 d ± 3.1 d in decompressed RY and 11.4 d ± 3.4 d in the tubeless RY group, P = 0.035). The postoperative pneumonia rate was lowest in the tubeless group and highest in the BII group (1.4% vs 4.6%, P = 0.01). Severe sore throat was noted in 59 (20.7%) members of the BII group, 18 (17.4%) members of the decompressed RY group and 6 (4.2%) members of the tubeless RY group. Fewer patients in the tubeless group complained of severe sore throat (P = 0.001).

CONCLUSION:

This study provides support for abandoning routine NG decompression in patients undergoing subtotal gastrectomy with Roux-en-Y gastrojejunostomy.

KEYWORDS:

Billroth II gastrojejunostomy; Gastric cancer; Nasogastric decompression; Radical distal gastrectomy; Roux-en-Y gastrojejunostomy

PMID:
22294828
PMCID:
PMC3261542
DOI:
10.3748/wjg.v18.i3.251
[Indexed for MEDLINE]
Free PMC Article

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