Timing of Nasogastric Tube Removal and Its Impact on Postoperative Bowel Function Recovery and Feeding Following Major Bowel Surgery in Children.

BACKGROUND

Although studies in adults have shown that early removal of the nasogastric tube (NGT) after major bowel surgery is safe and more beneficial than delayed removal, adoption of this practice in children has been slow due to limited supporting evidence. This study aimed to compare postoperative outcomes between early and delayed nasogastric tube removal in children undergoing major bowel surgery.

METHODS

A total of 102 children who underwent major bowel surgery were randomized into two groups: Group I (early removal) and Group II (delayed removal), with 51 patients in each group. In Group I, the NGT was removed 24 hours postoperatively, whereas in Group II, it was removed after the passage of either faeces or flatus. The primary outcome was the prevalence of vomiting, while secondary outcomes included the timing of return of bowel sounds and the achievement of full-scale feeding. Data were analyzed using Statistical Product and Service Solutions (SPSS) version 20 (IBM, SPSS, Chicago, IL, USA). Qualitative and quantitative variables were analyzed using the Chi-square test and Student's t-test, respectively. A p-value < 0.05 was considered statistically significant.

RESULTS

Vomiting occurred in 6 (11.8%) patients in the early group and 5 (9.8%) patients in the delayed group (p = 0.750). Bowel sounds returned significantly earlier in the early group (83 ± 11.67 hours) compared with the delayed group (97 ± 17.71 hours; p = 0.029). Full-scale feeding was achieved at 121.84 ± 13.67 hours in the early group and 132.63 ± 12.79 hours in the delayed group (p = 0.031).

CONCLUSION

This study reveals that early removal of the nasogastric tube might not significantly increase the rates of vomiting. However, it might lead to significantly reduced time to the return of bowel sounds and full scale feeding.