RESEARCH ARTICLE

“Fast Track” nasogastric decompression of rectal cancer surgery

  • Ka Li 1 ,
  • Zongguang Zhou , 1,2 ,
  • Zengrong Chen 1 ,
  • Yi Zhang 2 ,
  • Cun Wang 1,2
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  • 1. Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
  • 2. Institute of Digestive Surgery, West China Hospital, Sichuan University, Chengdu 610041, China

Received date: 08 Apr 2011

Accepted date: 16 Aug 2011

Published date: 05 Sep 2011

Copyright

2014 Higher Education Press and Springer-Verlag Berlin Heidelberg

Abstract

This study evaluates the application of fast track (FT) nasogastric decompression in patients who underwent anterior resection of rectal cancer. A randomized control trial was performed comparing the group with the fast track treatment (n =β57) and the group with traditional nasogastric decompression (n =β84). Preoperative characteristics and postoperative recovery indices were recorded and analyzed. The results indicate no significant differences in gender (P =β0.614), age (P =β0.653), tumor location (P =β0.113), and TNM stages (P =β0.054) were observed between the 2 groups. The differences in the type of resection, anastomosis, and adoption of protective colostomy were all not significant between the FT and the traditional group. During the first 24 hours after surgery, the volume of nasogastric drainage averaged 197 ml in the FT group and 155 ml in the traditional group (P =β0.197). The initiation of test-meal (P =β0.000), semiliquid diet (P =β0.002), and ordinary diet (P =β0.008) were all significantly shorter in the FT group. Furthermore, compared with the other group, the patients in the FT group enjoyed earlier removal of the abdominal drainage, urinary catheter, and shorter hospital stays (P =β0.000). Based on a correlation test, the duration of nasogastric decompression is related to the time of test-meal and semiliquid diet. The routine usage of nasogastric decompression in rectal surgery is unnecessary. The fast track procedure might help in facilitating postoperative functional and diet recovery, reducing the time of catheterization, and shortening hospital stay.

Cite this article

Ka Li , Zongguang Zhou , Zengrong Chen , Yi Zhang , Cun Wang . “Fast Track” nasogastric decompression of rectal cancer surgery[J]. Frontiers of Medicine, 2011 , 5(3) : 306 -309 . DOI: 10.1007/s11684-011-0154-6

Acknowledgements

This work was supported by the Foundation for the Author of National Excellent Doctoral Dissertation of China (Grant No. FANEDD 2007B66) and by the National Science Foundation of China (Grant No. 30801331).
1
Nelson R, Tse B, Edwards S. Systematic review of prophylactic nasogastric decompression after abdominal operations. Br J Surg 2005; 92(6): 673-680

DOI PMID

2
Nelson R, Edwards S, Tse B. Prophylactic nasogastric decompression after abdominal surgery. Cochrane Database Syst Rev 2007; (3): CD004929

PMID

3
Hasenberg T, Längle F, Reibenwein B, Schindler K, Post S, Spies C, Schwenk W, Shang E. Current perioperative practice in rectal surgery in Austria and Germany. Int J Colorectal Dis 2010; 25(7): 855-863

DOI PMID

4
Rao W, Zhang X, Zhang J, Yan R, Hu Z, Wang Q. The role of nasogastric tube in decompression after elective colon and rectum surgery: a meta-analysis. Int J Colorectal Dis 2011; 26(4): 423-429

DOI PMID

5
Yang Z, Zheng Q, Wang Z. Meta-analysis of the need for nasogastric or nasojejunal decompression after gastrectomy for gastric cancer. Br J Surg 2008; 95(7): 809-816

DOI PMID

6
Kelly MJ, Lloyd TD, Marshall D, Garcea G, Sutton CD, Beach M. A snapshot of MDT working and patient mapping in the UK colorectal cancer centres in 2002. Colorectal Dis 2003; 5(6): 577-581

DOI PMID

7
Wilmore DW, Kehlet H. Management of patients in fast track surgery. BMJ 2001; 322(7284): 473-476

DOI PMID

8
Schwenk W, Neudecker J, Raue W, Haase O, Müller JM. “Fast-track” rehabilitation after rectal cancer resection. Int J Colorectal Dis 2006; 21(6): 547-553

DOI PMID

9
Kehlet H. Fast-track colorectal surgery. Lancet 2008; 371(9615): 791-793

DOI PMID

10
Montgomery RC, Bar-Natan MF, Thomas SE, Cheadle WG. Postoperative nasogastric decompression: a prospective randomized trial. South Med J 1996; 89(11): 1063-1066

DOI PMID

11
Wichmann MW, Eben R, Angele MK, Brandenburg F, Goetz AE, Jauch KW. Fast-track rehabilitation in elective colorectal surgery patients: a prospective clinical and immunological single-centre study. ANZ J Surg 2007; 77(7): 502-507

DOI PMID

12
Bauer JJ, Gelernt IM, Salky BA, Kreel I. Is routine postoperative nasogastric decompression really necessary? Ann Surg 1985; 201(2): 233-236

DOI PMID

13
Li C, Mei JW, Yan M, Chen MM, Yao XX, Yang QM, Zhou R, Zhu ZG. Nasogastric decompression for radical gastrectomy for gastric cancer: a prospective randomized controlled study. Dig Surg 2011; 28(3): 167-172

DOI PMID

14
Cheatham ML, Chapman WC, Key SP, Sawyers JL. A meta-analysis of selective versus routine nasogastric decompression after elective laparotomy. Ann Surg 1995; 221(5): 469-476, discussion 476-478

DOI PMID

15
Wolff BG, Pembeton JH, van Heerden JA, Beart RW Jr, Nivatvongs S, Devine RM, Dozois RR, Ilstrup DM. Elective colon and rectal surgery without nasogastric decompression. A prospective, randomized trial. Ann Surg 1989; 209(6): 670-673, discussion 673-675

DOI PMID

16
Otchy DP, Wolff BG, van Heerden JA, Ilstrup DM, Weaver AL, Winter LD. Does the avoidance of nasogastric decompression following elective abdominal colorectal surgery affect the incidence of incisional hernia? Results of a prospective, randomized trial. Dis Colon Rectum 1995; 38(6): 604-608

DOI PMID

17
Lassen K, Hannemann P, Ljungqvist O, Fearon K, Dejong CH, von Meyenfeldt MF, Hausel J, Nygren J, Andersen J, Revhaug A. Patterns in current perioperative practice: survey of colorectal surgeons in five northern European countries. BMJ 2005; 330(7505): 1420-1421

DOI PMID

18
Zhou T, Wu XT, Zhou YJ, Huang X, Fan W, Li YC. Early removing gastrointestinal decompression and early oral feeding improve patients’ rehabilitation after colorectostomy. World J Gastroenterol 2006; 12(15): 2459-2463

PMID

19
Roig JV, García-Fadrique A, García Armengol J, Villalba FL, Bruna M, Sancho C, Puche J. Use of nasogastric tubes and drains after colorectal surgery. Have attitudes changed in the last 10 years? Cir Esp 2008; 83(2): 78-84 (in Spanish)

DOI PMID

20
Ng WQ, Neill J. Evidence for early oral feeding of patients after elective open colorectal surgery: a literature review. J Clin Nurs 2006; 15(6): 696-709

DOI PMID

21
Silk DB, Gow NM. Postoperative starvation after gastrointestinal surgery. Early feeding is beneficial. BMJ 2001; 323(7316): 761-762

DOI PMID

22
Keele AM, Bray MJ, Emery PW, Duncan HD, Silk DB. Two phase randomised controlled clinical trial of postoperative oral dietary supplements in surgical patients. Gut 1997; 40(3): 393-399

PMID

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