摘要
AIM: To determine whether routine nasogastric (NG) decompression benefitted patients undergoing radical gastric surgery. METHODS: Between January 1998 and December 2008, 519 patients who underwent distal gastrectomy for gastric cancer were retrospectively divided into 2 time-period cohorts; those treated with Billroth Ⅱ (BⅡ) reconstruction in the first 6 years and those with Roux-en-Y (RY) reconstruction in the last 5 years. In the latter group, the patients were further divided into 2 subgroups; with and without nasogastric decompression.RESULTS: Postoperatively, there were no significant differences in the number of anastomotic leaks between the 3 groups. In the tubeless RY group, time to semiliquid diet was significantly shorter than in the other 2 groups (4.4 d ± 1.4 d vs 7.2 d ± 1.3 d and 5.9 d ± 1.2 d, P = 0.005). The length of postoperative stay was significantly increased in patients with BⅡ reconstruction compared with patients with RY reconstruction with/without NG decompression (15.4 d ± 4.3 d in BⅡ group vs 12.6 d ± 3.1 d in decompressed RY and 11.4 d ± 3.4 d in the tubeless RY group, P = 0.035). The postoperative pneumonia rate was lowest in the tubeless group and highest in the BⅡ group (1.4% vs 4.6%, P = 0.01). Severe sore throat was noted in 59 (20.7%) members of the BⅡ group, 18 (17.4%) members of the decompressed RY group and 6 (4.2%) members of the tubeless RY group. Fewer patients in the tubeless group complained of severe sore throat (P = 0.001). CONCLUSION: This study provides support for abandoning routine NG decompression in patients undergoing subtotal gastrectomy with Roux-en-Y gastrojejunostomy.
AIM： To determine whether routine nasogastric （NG） decompression benefitted patients undergoing radical gastric surgery. METHODS： Between January 1998 and December 2008, 519 patients who underwent distal gastrectomy for gastric cancer were retrospectively divided into 2 time-period cohorts; those treated with Billroth Ⅱ （BⅡ） reconstruction in the first 6 years and those with Roux-en-Y （RY） reconstruction in the last 5 years. In the latter group, the patients were further divided into 2 subgroups; with and without nasogastric decompression.RESULTS： Postoperatively, there were no significant differences in the number of anastomotic leaks between the 3 groups. In the tubeless RY group, time to semiliquid diet was significantly shorter than in the other 2 groups （4.4 d ± 1.4 d vs 7.2 d ± 1.3 d and 5.9 d ± 1.2 d, P = 0.005）. The length of postoperative stay was significantly increased in patients with BⅡ reconstruction compared with patients with RY reconstruction with/without NG decompression （15.4 d ± 4.3 d in BⅡ group vs 12.6 d ± 3.1 d in decompressed RY and 11.4 d ± 3.4 d in the tubeless RY group, P = 0.035）. The postoperative pneumonia rate was lowest in the tubeless group and highest in the BⅡ group （1.4% vs 4.6%, P = 0.01）. Severe sore throat was noted in 59 （20.7%） members of the BⅡ group, 18 （17.4%） members of the decompressed RY group and 6 （4.2%） members of the tubeless RY group. Fewer patients in the tubeless group complained of severe sore throat （P = 0.001）. CONCLUSION： This study provides support for abandoning routine NG decompression in patients undergoing subtotal gastrectomy with Roux-en-Y gastrojejunostomy.
关键词
胃癌
减压
空肠
远端
无内胎
时间周期
患者
半流体
Nasogastric decompression Billroth Ⅱ gas- trojejunostomy Roux-en-Y gastrojejunostomy Radical distal gastrectomy Gastric cancer
