Naso-gastric or naso-jejunal decompression after partial distal gastrectomy for gastric cancer. Final results of a multicenter prospective randomized trial

Background Only a few, small, monocentric randomized controlled trials (RCTs) have compared routine vs. no placement of a nasogastric or nasojejunal tube decompression (NG/NJT) in patients undergoing partial distal gastrectomy (PDG) for gastric cancer. However, to our knowledge, no multicenter prosp...

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Published in:Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association 2014-10, Vol.17 (4), p.725-732
Main Authors: Pacelli, Fabio, Rosa, Fausto, Marrelli, Daniele, Morgagni, Paolo, Framarini, Massimo, Cristadoro, Luigi, Pedrazzani, Corrado, Casadei, Riccardo, Cozzaglio, Luca, Covino, Marcello, Donini, Annibale, Roviello, Franco, de Manzoni, Giovanni, Doglietto, Giovanni Battista
Format: Article
Language:English
Subjects:
Abdominal Surgery
Aged
Anastomosis, Roux-en-Y - methods
Cancer Research
Decompression, Surgical - methods
Female
Gastrectomy - methods
Gastric cancer
Gastroenterology
Gastroenterostomy - methods
Humans
Male
Medicine
Medicine & Public Health
Middle Aged
Oncology
Original Article
Postoperative Complications - etiology
Prospective Studies
Stomach Neoplasms - surgery
Surgical Oncology
Treatment Outcome
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Summary:Background Only a few, small, monocentric randomized controlled trials (RCTs) have compared routine vs. no placement of a nasogastric or nasojejunal tube decompression (NG/NJT) in patients undergoing partial distal gastrectomy (PDG) for gastric cancer. However, to our knowledge, no multicenter prospective RCT has analyzed the role of decompression after both the Billroth II (BII) procedure and Roux-en-Y (RY) gastrojejunostomy. The aim of this study was to determine whether NG/NJT prevents the consequences of postoperative ileus after PDG for gastric cancer after both BII reconstruction and RY. Methods Two hundred seventy patients undergoing PDG for gastric cancer were randomly assigned NG/NJT placement (NG/NJT group) or not (no-NG/NJT group) with either Billroth II gastrojejunostomy or Roux-en-Y gastrojejunostomy. The patients were monitored for postoperative complications, mortality, and postoperative course. Results By January 2010 to June 2012, among 270 patients undergoing PDG for gastric cancer, 134 were randomly assigned to NG/NJT placement (NG/NJT group) and 136 to no decompression (no-NG/NJT group). Time to passage of flatus was significantly shorter in the NG/NJT group than in the no-NG/NJT group, but only after RY reconstruction (3.3 ± 1.5 vs. 4.3 ± 1.6 days, P  
ISSN:1436-3291
1436-3305
DOI:10.1007/s10120-013-0319-x