Is routine nasogastric decompression after hepatic surgery necessary? A systematic review and meta-analysis

Zunjia Wen; Xin Zhang; Yingfei Liu; Lanzheng Bian; Junyu Chen; Li Wei

doi:10.1016/j.ijnurstu.2019.103406

Is routine nasogastric decompression after hepatic surgery necessary? A systematic review and meta-analysis

Int J Nurs Stud. 2019 Dec:100:103406. doi: 10.1016/j.ijnurstu.2019.103406. Epub 2019 Aug 26.

Authors

Zunjia Wen¹, Xin Zhang¹, Yingfei Liu¹, Lanzheng Bian¹, Junyu Chen¹, Li Wei²

Affiliations

¹ Children's Hospital of Nanjing Medical University, No.72 Guangzhou road, Gulou district, Nanjing, Jiangsu, China.
² Children's Hospital of Nanjing Medical University, No.72 Guangzhou road, Gulou district, Nanjing, Jiangsu, China. Electronic address: 13815889954@163.com.

PMID: 31629211
DOI: 10.1016/j.ijnurstu.2019.103406

Abstract

Objectives: Currently the nasogastric tube (NGT) is routinely inserted in clinical after abdominal surgery for decompression in China, yet the practice varies between regions, the role of NGT for the patients after hepatic surgery remains unclear. Therefore, this present meta-analysis aimed to assess the efficacy and safety of NGT placement after hepatic surgery.

Design: A systematic review and meta-analysis DATA SOURCES: PUBMED, EMBASE, Science Direct, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure (CNKI) and Wanfang Database (until Mar 30, 2019) were systematically searched.

Review methods: Randomized controlled studies (RCTs) comparing the efficacy and safety of NGT and no NGT treatment after hepatic surgery were included. Data were synthesized using a random-effects or fixed effect model according to the heterogeneity. Outcomes were presented as Mantel-Haenszel style odd ratios (ORs) or mean differences (MDs) with 95% confidence intervals (95% CIs).

Results: Seven studies with 1306 patients were eligible for inclusion. Compared with NGT treatment, the no NGT decompression could shorten the time to first defecation (MD -0.59; -0.79, -0.39), reduce the time to start diet (MD -0.46; -0.90, -0.03), and decrease the length of hospital stay (MD 0.48; -0.93, -0.03), but it could also increase the risk of NGT re-intubation (OR 6.8; 1.77, 26.72), no significant differences were detected on the first passage of flatus (MD -0.34; -0.86, 0.18), the incidence of nausea (OR 0.81; 0.40, 1.67), vomiting (OR 1.06; 0.19, 5.93), abdominal distention (OR 0.87; 0.60, 1.25).

Conclusion: Given that very limited information for some endpoints in this present meta-analysis, the routinely insertion of NGT after hepatic surgery is not justified, the no NGT decompression seems to be more beneficial to the prognosis of patients after hepatic surgery, more related studies on this issue are needed.

Keywords: Decompression; Hepatic surgery; Meta-analysis; Nasogastric tube; Review.

Publication types

Meta-Analysis
Systematic Review

MeSH terms

China
Humans
Intubation, Gastrointestinal*
Liver / surgery*