Post-Operative Nasogastric Decompression after Intestinal Surgery in Children: Systematic Review and Meta-Analysis

Author(s):

Zahra Fawzi A Alhaddad*, Taha Hussain Albohassan, Abdullah Mohammed Alharbi, Rawan Awadhallah Alsulami, Ahmed Saad Alromaihi, Ahmed Shafeeq Abualsaud, Muath Mohammed Almuqhim, Suliman khalid Abuhaimed, Khalid Saad Alshahrani, Abdullah Hekmat Alameer and Khalifah Sulaiman Alsuqayh

Background: Nasogastric decompression the usage of a Nasogastric Tube (NGT) has been robotically executed after intestinal surgery as it’s far believed that the drainage of gastrointestinal content and intraluminal air can prevent postoperative complications consisting of an anastomotic leak, wound dehiscence, pulmonary headaches, nausea, and vomiting at the same time as stimulating the return of bowel feature, and shortening the length of hospital stay. But, ordinary postoperative NGT placement can cause discomfort and pain in children. Aim: This work aims to determine the efficacy and safety of postoperative nasogastric decompression (NGT), in intestinal surgery children. Methodology: A systematic search was performed over different medical databases to identify general surgery studies, which studied the outcome of the NGT group versus the non-NGT group of intestinal surgery children. We conducted a meta-analysis process on Length of Hospital Stay (LOS), as a primary efficacy outcome, and on complications rate (vomiting, abdominal distention, and NGT reinsertion) as secondary safety outcomes. Five studies were identified involving 507 patients, with 241 patients in the NGT group, and 266 patients in the non-NGT group. Our meta-analysis process showed a non-significant difference in LOS, overall complications rate and NGT reinsertion rate in the NGT group compared to the nonNGT group (p>0.05 respectively). Conclusion: To conclude, routine postoperative nasogastric decompression in children undergoing intestinal surgery has no benefit in reducing postoperative complications or the return of bowel function while causing patient discomfort. In addition, postoperative management without nasogastric decompression shortens the time to first oral intake, time to full oral intake, and the length of hospital stay. Therefore, routine postoperative nasogastric decompression can be safely abandoned in children undergoing intestinal surgery.