POSTOPERATIVE NASOGASTRIC DECOMPRESSION IS NOT WARRANTED IN ELECTIVE CLOSURE OF GUT STOMAS AND BILIOENTERIC ANASTAMOSIS: A RANDOMIZED CONTROLLED TRIAL

Objective: To compare the outcome of postoperative nasogastric decompression versus no nasogastric decompression in cases of elective closure of gut stomas and bilioenteric anastamosis. Material and Methods: This randomized trial was conducted from 01-01-2006 to 31-10-3006 at Lady reading Hospital, Peshawar on 119 patients admitted for stomal closure or Bilioenteric anastamosis. Group A included 58 patients subjected to postoperative nasogastric decompression and group B included 61 patients not subjected to postoperative nasogastric decompression. Out of 119 patients, 61 (Group A=30; Group B=31) patients underwent gut stomas closure and 58 patients (Group A=28; Group B=30) underwent Bilioenteric Anastamosis. Pediatric age group, oesophagogastric disease, emergency procedures and pre-operative co-morbid conditions were excluded. Results: The male to female ratio in group A was 4:1 and in group B was 2.85:1. The morbidity between group A (60.0%) and group B (48.38%) was insignificant (p>0.05). No mortality was observed during hospital stay in both groups. Length of hospital stay was 7.93+1.27 days in group A versus 6.54+0.85 days in group B. The number of nasogastric reinsertions was in 6 patients; three in either group with a delay of 2.6 days for duration of 3.1 days. Abdominal distension was observed in 12 (60%) cases of stomal closure in group A versus 7 (22.5%) in group B. In patients undergoing bilioenteric anastamosis the mean stay in group A was no more than group B. Conclusion: Increase hospital stay and complication rates were observed in patiants receiving nasogastric decompression compered to those without NG tubes.