Feasibility study of removal of gastric tube for gastrointestinal decompression after minimally invasive esophageal cancer surgery_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

SUN Yaohui , YANG Lei , WANG Fei ,  ZHANG Linyou

Department of Thoracic Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150001, P.R.China;

Corresponding author：

ZHANG Linyou, Email: hmulyzhang@outlook.com

Keywords：

Minimally invasive esophageal cancer surgery; gastric tube; complications; enhanced recovery after surgery (ERAS); treatment

DOI：

10.7507/1007-4848.201911057

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To explore the feasibility of decompression without gastric tube after minimally invasive esophageal cancer surgery.Methods Seventy-two patients who underwent minimally invasive esophageal cancer resection at the Department of Thoracic Surgery, The Second Affiliated Hospital of Harbin Medical University from 2016 to 2018 were selected as a trial group including 68 males and 4 females with an average age of 58.5±7.9 years, who did not use gastric tube for gastrointestinal decompression after surgery. Seventy patients who underwent the same operation from 2013 to 2015 were selected as the control group, including 68 males and 2 females, with an average age of 59.1±6.9 years, who were indwelled with gastric tube for decompression after surgery. We observed and compared the intraoperative and postoperative indicators and complications of the two groups.Results There were no significant differences between the two groups in operation time, intraoperative blood loss, postoperative level of serum albumin, postoperative nasal jejunal nutrition, whether to enter the ICU postoperatively, death within 30 days after surgery, anastomotic leakage, lung infection, vomiting, bloating or hoarseness (P>0.05). No gastroparesis occurred in either group. Compared with the control group, the recovery time of the bowel sounds and the first exhaust time after the indwelling in the trial group were significantly shorter, and the total hospitalization cost, the incidence of nausea, sore throat, cough, foreign body sensation and sputum difficulty were significantly lower (P<0.05).Conclusion It is feasible to remove the gastric tube for gastrointestinal decompression after minimally invasive esophageal cancer surgery, which will not increase the incidence of postoperative complications, instead, accelerate the postoperative recovery of patients.

Citation： SUN Yaohui, YANG Lei, WANG Fei, ZHANG Linyou. Feasibility study of removal of gastric tube for gastrointestinal decompression after minimally invasive esophageal cancer surgery. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2020, 27(7): 819-823. doi: 10.7507/1007-4848.201911057 Copy

1.	Chen W, Sun K, Zheng R, et al. Cancer incidence and mortality in China, 2014. Chin J Cancer Res, 2018, 30(1): 1-12.
2.	Kunstman JW, Klemen ND, Fonseca AL, et al. Nasogastric drainage may be unnecessary after pancreaticoduodenectomy: a comparison of routine vs selective decompression. J Am Coll Surg, 2013, 217(3): 481-488.
3.	Gaignard E, Bergeat D, Courtin-Tanguy L, et al. Is systematic nasogastric decompression after pancreaticoduodenectomy really necessary? Langenbecks Arch Surg, 2018, 403(5): 573-580.
4.	Ichida H, Imamura H, Yoshimoto J, et al. Randomized controlled trial for evaluation of the routine use of nasogastric tube decompression after elective liver surgery. J Gastrointest Surg, 2016, 20(7): 1324-1330.
5.	Kimura Y, Yano H, Iwazawa T, et al. One-day nasogastric tube decompression after distal gastrectomy: a prospective randomized study. Surg Today, 2017, 47(9): 1080-1085.
6.	Sato T, Takayama T, So K, et al. Is retention of a nasogastric tube after esophagectomy a risk factor for postoperative respiratory tract infection? J Infect Chemother, 2007, 13(2): 109-113.
7.	Gooszen JAH, Goense L, Gisbertz SS, et al. Intrathoracic versus cervical anastomosis and predictors of anastomotic leakage after oesophagectomy for cancer. Br J Surg, 2018, 105(5): 552-560.
8.	Kassis ES, Kosinski AS, Ross P Jr, et al. Predictors of anastomotic leak after esophagectomy: an analysis of the society of thoracic surgeons general thoracic database. Ann Thorac Surg, 2013, 96(6): 1919-1926.
9.	Huang J, Zhou Y, Wang C, et al. Logistic regression analysis of the risk factors of anastomotic fistula after radical resection of esophageal-cardiac cancer. Thorac Cancer, 2017, 8(6): 666-671.
10.	Shiozaki A, Fujiwara H, Okamura H, et al. Risk factors for postoperative respiratory complications following esophageal cancer resection. Oncol Lett, 2012, 3(4): 907-912.
11.	Molena D, Mungo B, Stem M, et al. Incidence and risk factors for respiratory complications in patients undergoing esophagectomy for malignancy: a NSQIP analysis. Semin Thorac Cardiovasc Surg, 2014, 26(4): 287-294.
12.	Konradsson M, Nilsson M. Delayed emptying of the gastric conduit after esophagectomy. J Thorac Dis, 2019, 11(Suppl 5): S835-S844.
13.	Benedix F, Willems T, Kropf S, et al. Risk factors for delayed gastric emptying after esophagectomy. Langenbecks Arch Surg, 2017, 402(3): 547-554.
14.	Sun HB, Liu XB, Zhang RX, et al. Early oral feeding following thoracolaparoscopic oesophagectomy for oesophageal cancer. Eur J Cardiothorac Surg, 2015, 47(2): 227-233.
15.	Hayashi M, Kawakubo H, Shoji Y, et al. Analysis of the effect of early versus conventional nasogastric tube removal on postoperative complications after transthoracic esophagectomy: a single-center, randomized controlled trial. World J Surg, 2019, 43(2): 580-589.
16.	柯键, 刘美. 留置鼻胃管成人病人舒适度影响因素及保护措施. 全科护理, 2019, 17(4): 407-410.

1. Chen W, Sun K, Zheng R, et al. Cancer incidence and mortality in China, 2014. Chin J Cancer Res, 2018, 30(1): 1-12.
2. Kunstman JW, Klemen ND, Fonseca AL, et al. Nasogastric drainage may be unnecessary after pancreaticoduodenectomy: a comparison of routine vs selective decompression. J Am Coll Surg, 2013, 217(3): 481-488.
3. Gaignard E, Bergeat D, Courtin-Tanguy L, et al. Is systematic nasogastric decompression after pancreaticoduodenectomy really necessary? Langenbecks Arch Surg, 2018, 403(5): 573-580.
4. Ichida H, Imamura H, Yoshimoto J, et al. Randomized controlled trial for evaluation of the routine use of nasogastric tube decompression after elective liver surgery. J Gastrointest Surg, 2016, 20(7): 1324-1330.
5. Kimura Y, Yano H, Iwazawa T, et al. One-day nasogastric tube decompression after distal gastrectomy: a prospective randomized study. Surg Today, 2017, 47(9): 1080-1085.
6. Sato T, Takayama T, So K, et al. Is retention of a nasogastric tube after esophagectomy a risk factor for postoperative respiratory tract infection? J Infect Chemother, 2007, 13(2): 109-113.
7. Gooszen JAH, Goense L, Gisbertz SS, et al. Intrathoracic versus cervical anastomosis and predictors of anastomotic leakage after oesophagectomy for cancer. Br J Surg, 2018, 105(5): 552-560.
8. Kassis ES, Kosinski AS, Ross P Jr, et al. Predictors of anastomotic leak after esophagectomy: an analysis of the society of thoracic surgeons general thoracic database. Ann Thorac Surg, 2013, 96(6): 1919-1926.
9. Huang J, Zhou Y, Wang C, et al. Logistic regression analysis of the risk factors of anastomotic fistula after radical resection of esophageal-cardiac cancer. Thorac Cancer, 2017, 8(6): 666-671.
10. Shiozaki A, Fujiwara H, Okamura H, et al. Risk factors for postoperative respiratory complications following esophageal cancer resection. Oncol Lett, 2012, 3(4): 907-912.
11. Molena D, Mungo B, Stem M, et al. Incidence and risk factors for respiratory complications in patients undergoing esophagectomy for malignancy: a NSQIP analysis. Semin Thorac Cardiovasc Surg, 2014, 26(4): 287-294.
12. Konradsson M, Nilsson M. Delayed emptying of the gastric conduit after esophagectomy. J Thorac Dis, 2019, 11(Suppl 5): S835-S844.
13. Benedix F, Willems T, Kropf S, et al. Risk factors for delayed gastric emptying after esophagectomy. Langenbecks Arch Surg, 2017, 402(3): 547-554.
14. Sun HB, Liu XB, Zhang RX, et al. Early oral feeding following thoracolaparoscopic oesophagectomy for oesophageal cancer. Eur J Cardiothorac Surg, 2015, 47(2): 227-233.
15. Hayashi M, Kawakubo H, Shoji Y, et al. Analysis of the effect of early versus conventional nasogastric tube removal on postoperative complications after transthoracic esophagectomy: a single-center, randomized controlled trial. World J Surg, 2019, 43(2): 580-589.
16. 柯键, 刘美. 留置鼻胃管成人病人舒适度影响因素及保护措施. 全科护理, 2019, 17(4): 407-410.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Feasibility study of removal of gastric tube for gastrointestinal decompression after minimally invasive esophageal cancer surgery

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content