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Is routine nasogastric decompression after hepatic surgery necessary? A systematic review and meta-analysis.

Authors
  • Wen, Zunjia1
  • Zhang, Xin1
  • Liu, Yingfei1
  • Bian, Lanzheng1
  • Chen, Junyu1
  • Wei, Li2
  • 1 Children's Hospital of Nanjing Medical University, No.72 Guangzhou road, Gulou district, Nanjing, Jiangsu, China. , (China)
  • 2 Children's Hospital of Nanjing Medical University, No.72 Guangzhou road, Gulou district, Nanjing, Jiangsu, China. Electronic address: [email protected] , (China)
Type
Published Article
Journal
International journal of nursing studies
Publication Date
Dec 01, 2019
Volume
100
Pages
103406–103406
Identifiers
DOI: 10.1016/j.ijnurstu.2019.103406
PMID: 31629211
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Currently the nasogastric tube (NGT) is routinely inserted in clinical after abdominal surgery for decompression in China, yet the practice varies between regions, the role of NGT for the patients after hepatic surgery remains unclear. Therefore, this present meta-analysis aimed to assess the efficacy and safety of NGT placement after hepatic surgery. A systematic review and meta-analysis DATA SOURCES: PUBMED, EMBASE, Science Direct, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure (CNKI) and Wanfang Database (until Mar 30, 2019) were systematically searched. Randomized controlled studies (RCTs) comparing the efficacy and safety of NGT and no NGT treatment after hepatic surgery were included. Data were synthesized using a random-effects or fixed effect model according to the heterogeneity. Outcomes were presented as Mantel-Haenszel style odd ratios (ORs) or mean differences (MDs) with 95% confidence intervals (95% CIs). Seven studies with 1306 patients were eligible for inclusion. Compared with NGT treatment, the no NGT decompression could shorten the time to first defecation (MD -0.59; -0.79, -0.39), reduce the time to start diet (MD -0.46; -0.90, -0.03), and decrease the length of hospital stay (MD 0.48; -0.93, -0.03), but it could also increase the risk of NGT re-intubation (OR 6.8; 1.77, 26.72), no significant differences were detected on the first passage of flatus (MD -0.34; -0.86, 0.18), the incidence of nausea (OR 0.81; 0.40, 1.67), vomiting (OR 1.06; 0.19, 5.93), abdominal distention (OR 0.87; 0.60, 1.25). Given that very limited information for some endpoints in this present meta-analysis, the routinely insertion of NGT after hepatic surgery is not justified, the no NGT decompression seems to be more beneficial to the prognosis of patients after hepatic surgery, more related studies on this issue are needed. Copyright © 2019 The Authors. Published by Elsevier Ltd.. All rights reserved.

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