Pooled Analysis of the Routine Nasogastric Decompression Necessity for Elective Gastrectomy

Background: Nasogastric decompression is routinely used for intestinal drainage or decompression after gastrectomy. However, nowadays its efficacy is under debate. Objectives: The purpose of this study was to investigate the efficacy and necessity of nasogastric decompression in radical gastrectomy for gastric cancer. Methods: Two PubMed and EMBASE electronic databases were retrieved by November 2018. A prospective randomized controlled trial (RCT) and comparison of nasogastric decompression with and without nasogastric decompression after gastrectomy are required for eligible studies. Results: A total of 1,885 cases were included in 13 randomized controlled studies. There were 941 cases in nasogastric decompression group and 944 cases in non-nasogastric decompression group after gastrectomy. The patients in non-nasogastric decompression group had significantly shorter time of bowel sound return (WMD = -0.20, 95% CIs = -0.38 0.02, P = 0.03), shorter time of first oral intake (WMD = -0.58, 95% CIs = -0.92 0.24, P = 0.0007), faster tolerance to semi-solid diet (WMD = -0.65, 95% CIs = -0.96 0.34, P < 0.0001), and shorter time of postoperative hospital stay (WMD = -0.99, 95% CIs = -1.70 0.27, P = 0.007). No statistically significant differences were observed in the first time to passage of flatus, vomiting, mortality rates, total complications, gastrointestinal complications, wound complications, respiratory complications, anastomosis or duodenal stump fistula, and general complications. Conclusions: The routine nasogastric decompression was not recommended for patients after elective gastrectomy.