Role of nasogastric intubation after small bowel anastomosis.

OBJECTIVE To determine advantages and disadvantages of postoperative nasogastric intubation after small bowel anastomosis. STUDY DESIGN Quasi experimental. PLACE AND DURATION OF STUDY Surgical Unit-I, Holy Family Hospital, Rawalpindi, from December 2003 to December 2006. METHODOLOGY A total of 112 patients, undergoing small bowel anastomosis were equally divided in group I and II with and without postoperative nasogastric intubation respectively. Variables compared were number of patients having episodes of vomiting, change in abdominal girth, the time for onset of bowel sounds, time to begin per oral fluids, length of hospitalization and postoperative complications. RESULTS In group-I, nasogastric tube was removed on an average after 3.1 days. Average postoperative nasogastric output was 357, 154 and 64 ml/day for day 1, 2 and 3 respectively. There was no statistically significant difference between two groups in abdominal girth before and after operation, frequency of vomiting, time taken for onset of bowel sounds and start of oral sips after operation, frequency of wound infection, anastomotic leak and mortality (p>0.05). Length of postoperative hospital stay and frequency of postoperative respiratory complications were more in group-I as compared to group-II (p<0.05). CONCLUSION Nasogastric decompression does not provide added advantage after small bowel anastomosis.