Objective To explore the feasibility and safety of non-gastrointestinal decompression after esophagectomy and the necessity of gastric tube or the time to remove gastric tube. Methods Thirty patients with esophageal cancer who underwent surgical treatment in the Department of Thoracic and Cardiovascular Surgery, Nanjing Drum Tower Hospital, were included in the trial from June to October 2017. The patients were randomly and equally assigned to a trial group (non-gastrointestinal decompression) or a control group (gastrointestinal decompression). There was no significant difference in age (P=1.000), sex (P=1.000), tumor location (P=0.732), pathological type (P=1.000), pathological stage (P=0.507), and operation time (P=0.674) between the two groups. The clinical effect between the two groups were compared. Results There was no statistical difference in incidences of anastomotic leakage (P=1.000), anastomotic bleeding (P=1.000), gastroesophageal reflux (P=1.000) between the two groups. And there was no statistical difference in time of the first flatus (P=0.629) and the first bowel movement (P=0.599) after operation between the two groups. Conclusion Without gastrointestinal decompression after Ivor Lewis esophagectomy does not increase the incidences of anastomotic leakage, anastomotic bleeding and gastroesophageal reflux, and has no significant effect on the recovery of gastrointestinal function. Without gastrointestinal decompression after Ivor Lewis esophagectomy is safe and feasible. Removing gastric tube on the second day after operation is reasonable and feasible.
ObjectiveTo investigate safety and feasibility of laparoscopic common bile duct exploration (LCBDE) without preoperative prophylactic gastrointestinal decompression.MethodsA prospective study was conducted on the patients with choledocholithiasis and cholecystolithiasis scheduled to undergo LCBDE plus laparoscopic cholecystectomy in this hospital from January 2016 to December 2017. All the patients were randomly divided into a gastrointestinal decompression group and a non-gastrointestinal decompression group by the same researcher according to the random number table method. The general conditions, intraoperative status and postoperative status of patients in the two groups were compared.ResultsA total of 286 patients were enrolled in this study, including 120 in the non-gastrointestinal decompression group and 166 in the gastrointestinal decompression group. There were no significant differences in the general data such as the age, gender, smoking history, drinking history, preoperative complications, results of preoperative laboratory examination, and preoperative anesthesia score between the two groups (P>0.050). The time of oral feeding in the non-gastrointestinal decompression group was significantly earlier than that in the gastrointestinal decompression group (t=2.181, P=0.030). There were no significant differences in the bleeding volume, operative time, anal ventilation time, total hospitalization time, and postoperative hospitalization time between the two groups (P>0.050). The incidences of nausea/vomiting and poor appetite in the non-gastrointestinal decompression were significantly lower than those in the gastrointestinal decompression group (χ2=5.098, P=0.024; χ2=4.905, P=0.027). There were no significant differences in the incidences of other complications between the two groups (P>0.050).ConclusionFrom results of this study, prophylactic gastrointestinal decompression should not be recommended for patients undergoing LCBDE.