This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citing articles on HighWire  • Citing articles on ISI (4)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Critical Care/ Intensive Care Medicine  • Adult Critical Care  • Evidence-Based Medicine  • Gastrointestinal/ Upper Foregut  • Review  • Alert me on articles by topic

A Meta-analysis of Recent Literature

Hester Vermeulen, RN, MSc; Marja N. Storm-Versloot, RN, MSc; Olivier R. C. Busch, MD, PhD; Dirk T. Ubbink, MD, PhD

Arch Surg. 2006;141:307-314.

Objective  To determine whether refraining from nasogastric intubation (NGI) in patients after abdominal surgery will result in the same therapeutic effectiveness as using NGI.

Data Source  We identified randomized trials from the Cochrane Central Register of Controlled Trials published between January 1990 and January 2005.

Study Selection  Two of us independently selected trials based on randomization, abdominal surgery in patients, early vs late removal of the NGI, and reporting at least 1 of the following end points: hospital stay, gastrointestinal function, and postoperative complications.

Data Extraction  Two of us independently performed trial quality assessment and data extraction. Trials were judged using a structured list that included factors relating to internal and external validity. Data were entered and analyzed by means of dedicated software from the Cochrane Collaboration.

Data Synthesis  Seventeen randomized trials met the inclusion criteria. Meta-analysis showed that NGI does not offer any clinically relevant benefits for patients after abdominal surgery, such as recovery of gastrointestinal function or reduction of postoperative complications (relative risk, 1.18; 95% confidence interval, 0.98-1.42). Moreover, NGI showed some undesired effects, such as discomfort (in 60% of the NGI patients) and a later return to a liquid diet (weighted mean difference, 0.65 days; 95% confidence interval, 0.38-0.92 days) or a regular diet, whereas hospital stay was not shortened.

Conclusions  Routine NGI seems to serve no beneficial purpose and may even be harmful in patients after modern abdominal surgery; also, it is uncomfortable. Therefore, NGI is recommended only as a therapeutic approach.

Author Affiliations: Departments of Surgery (Mss Vermeulen and Storm-Versloot and Drs Busch and Ubbink) and Clinical Epidemiology and Biostatistics (Dr Ubbink), Academic Medical Center, Amsterdam, the Netherlands.

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Review: routine NG decompression after abdominal surgery delays return of bowel function and increases pulmonary complications
Brennan
Evid. Based Nurs. 2008;11:55-55.
FULL TEXT