Zhonghua yi xue za zhi · 2012
[Necessity of routine nasogastric decompression after gastrectomy for gastric cancer: a meta-analysis].
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Chen Ke, Mou Yi-ping, Xu Xiao-wu, Xie Kun, Zhou Wei
Аннотация
OBJECTIVE: To evaluate the necessity of routine nasogastric decompression after radical gastrectomy for gastric cancer with systematic review and Meta-analysis.
METHODS: The literature databases prior to September 2011 were extensively searched to retrieve the randomized controlled trials (RCT) with a relevance of study goal. The inclusion and exclusion criteria were formulated. After quality evaluation, the data were extracted. The Cochrane collaboration RevMan 5.1 version software was used for Meta-analysis.
RESULTS: Seven RCT studies fulfilled the inclusion criteria for Meta-analysis. The total sample size of these studies was 871 cases. Those without a nasogastric tube routinely inserted experienced a marginal earlier time to flatus [weighted mean difference (WMD) = 0.10 days, 95% confidence interval (CI) 0.00 - 0.30, P = 0.05], a significant earlier time to oral diet [WMD = 0.43 days, 95%CI 0.25 - 0.61, P < 0.01], a significant shorter hospital stay [WMD = 0.60 days, 95%CI 0.15 - 1.18, P = 0.01) and a marginal decrease in pulmonary complications [relative risk (RR) = 1.30, 95%CI 1.00 - 1.68, P = 0.05)]. The postoperative rates of anastomotic leakage, morbidity and mortality were similar between two groups.
CONCLUSION: Except for severe vomiting or abdominal distension, nasogastric tubes should not be used routinely in gastric cancer patients undergoing radical surgery.
METHODS: The literature databases prior to September 2011 were extensively searched to retrieve the randomized controlled trials (RCT) with a relevance of study goal. The inclusion and exclusion criteria were formulated. After quality evaluation, the data were extracted. The Cochrane collaboration RevMan 5.1 version software was used for Meta-analysis.
RESULTS: Seven RCT studies fulfilled the inclusion criteria for Meta-analysis. The total sample size of these studies was 871 cases. Those without a nasogastric tube routinely inserted experienced a marginal earlier time to flatus [weighted mean difference (WMD) = 0.10 days, 95% confidence interval (CI) 0.00 - 0.30, P = 0.05], a significant earlier time to oral diet [WMD = 0.43 days, 95%CI 0.25 - 0.61, P < 0.01], a significant shorter hospital stay [WMD = 0.60 days, 95%CI 0.15 - 1.18, P = 0.01) and a marginal decrease in pulmonary complications [relative risk (RR) = 1.30, 95%CI 1.00 - 1.68, P = 0.05)]. The postoperative rates of anastomotic leakage, morbidity and mortality were similar between two groups.
CONCLUSION: Except for severe vomiting or abdominal distension, nasogastric tubes should not be used routinely in gastric cancer patients undergoing radical surgery.