Trial Information

Role of Routine Nasogastric Decompression After Subtotal Gastrectomy

Nasogastric decompression is an intra-operative routine in most of the time to facilitate
exposure of operative field during elective subtotal gastrectomy, but whether it should be
retained post-operatively is controversial. Nasogastric decompression helps to drain the
gastric remnant in case there is edema around the gastrojejunostomy, ileus and delayed
gastric emptying, which can theoretically relieve nausea and abdominal distension. Besides,
it may help decrease diaphragmatic splintage and hence decrease chance of chest infection if
ileus occurs. However, nasogastric intubation could cause patient discomfort; also it has
been shown that it would cause gastroesophageal reflux which may be associated with chest
complication. There have been studies showing that routine post-operative nasogastric
decompression is not necessary for gastrectomy in general, but the role in subtotal
gastrectomy for stomach cancer is not well defined.