Naso-gastric or naso-jejunal decompression after partial distal gastrectomy for gastric cancer. Final results of a multicenter prospective randomized trial

Fabio Pacelli; Fausto Rosa; Daniele Marrelli; Paolo Morgagni; Massimo Framarini; Luigi Cristadoro; Corrado Pedrazzani; Riccardo Casadei; Luca Cozzaglio; Marcello Covino; Annibale Donini; Franco Roviello; Giovanni de Manzoni; Giovanni Battista Doglietto

doi:10.1007/s10120-013-0319-x

Naso-gastric or naso-jejunal decompression after partial distal gastrectomy for gastric cancer. Final results of a multicenter prospective randomized trial

Fabio Pacelli, Fausto Rosa, Daniele Marrelli, Paolo Morgagni, Massimo Framarini, Luigi Cristadoro, Corrado Pedrazzani, Riccardo Casadei, Luca Cozzaglio, Marcello Covino, Annibale Donini, Franco Roviello, Giovanni de Manzoni, Giovanni Battista Doglietto

Istituto Clinico Humanitas

Research output: Contribution to journal › Article › peer-review

Abstract

Background: Only a few, small, monocentric randomized controlled trials (RCTs) have compared routine vs. no placement of a nasogastric or nasojejunal tube decompression (NG/NJT) in patients undergoing partial distal gastrectomy (PDG) for gastric cancer. However, to our knowledge, no multicenter prospective RCT has analyzed the role of decompression after both the Billroth II (BII) procedure and Roux-en-Y (RY) gastrojejunostomy.

The aim of this study was to determine whether NG/NJT prevents the consequences of postoperative ileus after PDG for gastric cancer after both BII reconstruction and RY.

Methods: Two hundred seventy patients undergoing PDG for gastric cancer were randomly assigned NG/NJT placement (NG/NJT group) or not (no-NG/NJT group) with either Billroth II gastrojejunostomy or Roux-en-Y gastrojejunostomy. The patients were monitored for postoperative complications, mortality, and postoperative course.

Results: By January 2010 to June 2012, among 270 patients undergoing PDG for gastric cancer, 134 were randomly assigned to NG/NJT placement (NG/NJT group) and 136 to no decompression (no-NG/NJT group). Time to passage of flatus was significantly shorter in the NG/NJT group than in the no-NG/NJT group, but only after RY reconstruction (3.3 ± 1.5 vs. 4.3 ± 1.6 days, P

No significant differences in postoperative mortality or morbidity, especially anastomotic leakage or intra-abdominal sepsis, were observed between the groups.

Conclusion: Routine placement of an NG/NJT after BII and RY PDG is not necessary in elective surgery for gastric cancer.

Original language	English
Pages (from-to)	725-732
Number of pages	8
Journal	Gastric Cancer
Volume	17
Issue number	4
DOIs	https://doi.org/10.1007/s10120-013-0319-x
Publication status	Published - Sep 20 2014

Keywords

Gastric cancer
Gastric decompression
Partial distal gastrectomy

ASJC Scopus subject areas

Oncology
Gastroenterology
Cancer Research
Medicine(all)

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10.1007/s10120-013-0319-x

Cite this

Pacelli, F., Rosa, F., Marrelli, D., Morgagni, P., Framarini, M., Cristadoro, L., Pedrazzani, C., Casadei, R., Cozzaglio, L., Covino, M., Donini, A., Roviello, F., de Manzoni, G., & Doglietto, G. B. (2014). Naso-gastric or naso-jejunal decompression after partial distal gastrectomy for gastric cancer. Final results of a multicenter prospective randomized trial. Gastric Cancer, 17(4), 725-732. https://doi.org/10.1007/s10120-013-0319-x

Pacelli, F, Rosa, F, Marrelli, D, Morgagni, P, Framarini, M, Cristadoro, L, Pedrazzani, C, Casadei, R, Cozzaglio, L, Covino, M, Donini, A, Roviello, F, de Manzoni, G & Doglietto, GB 2014, 'Naso-gastric or naso-jejunal decompression after partial distal gastrectomy for gastric cancer. Final results of a multicenter prospective randomized trial', Gastric Cancer, vol. 17, no. 4, pp. 725-732. https://doi.org/10.1007/s10120-013-0319-x

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title = "Naso-gastric or naso-jejunal decompression after partial distal gastrectomy for gastric cancer. Final results of a multicenter prospective randomized trial",

abstract = "Background: Only a few, small, monocentric randomized controlled trials (RCTs) have compared routine vs. no placement of a nasogastric or nasojejunal tube decompression (NG/NJT) in patients undergoing partial distal gastrectomy (PDG) for gastric cancer. However, to our knowledge, no multicenter prospective RCT has analyzed the role of decompression after both the Billroth II (BII) procedure and Roux-en-Y (RY) gastrojejunostomy.The aim of this study was to determine whether NG/NJT prevents the consequences of postoperative ileus after PDG for gastric cancer after both BII reconstruction and RY.Methods: Two hundred seventy patients undergoing PDG for gastric cancer were randomly assigned NG/NJT placement (NG/NJT group) or not (no-NG/NJT group) with either Billroth II gastrojejunostomy or Roux-en-Y gastrojejunostomy. The patients were monitored for postoperative complications, mortality, and postoperative course.Results: By January 2010 to June 2012, among 270 patients undergoing PDG for gastric cancer, 134 were randomly assigned to NG/NJT placement (NG/NJT group) and 136 to no decompression (no-NG/NJT group). Time to passage of flatus was significantly shorter in the NG/NJT group than in the no-NG/NJT group, but only after RY reconstruction (3.3 ± 1.5 vs. 4.3 ± 1.6 days, P No significant differences in postoperative mortality or morbidity, especially anastomotic leakage or intra-abdominal sepsis, were observed between the groups.Conclusion: Routine placement of an NG/NJT after BII and RY PDG is not necessary in elective surgery for gastric cancer.",

keywords = "Gastric cancer, Gastric decompression, Partial distal gastrectomy",

author = "Fabio Pacelli and Fausto Rosa and Daniele Marrelli and Paolo Morgagni and Massimo Framarini and Luigi Cristadoro and Corrado Pedrazzani and Riccardo Casadei and Luca Cozzaglio and Marcello Covino and Annibale Donini and Franco Roviello and {de Manzoni}, Giovanni and Doglietto, {Giovanni Battista}",

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doi = "10.1007/s10120-013-0319-x",

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T1 - Naso-gastric or naso-jejunal decompression after partial distal gastrectomy for gastric cancer. Final results of a multicenter prospective randomized trial

AU - Pacelli, Fabio

AU - Rosa, Fausto

AU - Marrelli, Daniele

AU - Morgagni, Paolo

AU - Framarini, Massimo

AU - Cristadoro, Luigi

AU - Pedrazzani, Corrado

AU - Casadei, Riccardo

AU - Cozzaglio, Luca

AU - Covino, Marcello

AU - Donini, Annibale

AU - Roviello, Franco

AU - de Manzoni, Giovanni

AU - Doglietto, Giovanni Battista

PY - 2014/9/20

Y1 - 2014/9/20

N2 - Background: Only a few, small, monocentric randomized controlled trials (RCTs) have compared routine vs. no placement of a nasogastric or nasojejunal tube decompression (NG/NJT) in patients undergoing partial distal gastrectomy (PDG) for gastric cancer. However, to our knowledge, no multicenter prospective RCT has analyzed the role of decompression after both the Billroth II (BII) procedure and Roux-en-Y (RY) gastrojejunostomy.The aim of this study was to determine whether NG/NJT prevents the consequences of postoperative ileus after PDG for gastric cancer after both BII reconstruction and RY.Methods: Two hundred seventy patients undergoing PDG for gastric cancer were randomly assigned NG/NJT placement (NG/NJT group) or not (no-NG/NJT group) with either Billroth II gastrojejunostomy or Roux-en-Y gastrojejunostomy. The patients were monitored for postoperative complications, mortality, and postoperative course.Results: By January 2010 to June 2012, among 270 patients undergoing PDG for gastric cancer, 134 were randomly assigned to NG/NJT placement (NG/NJT group) and 136 to no decompression (no-NG/NJT group). Time to passage of flatus was significantly shorter in the NG/NJT group than in the no-NG/NJT group, but only after RY reconstruction (3.3 ± 1.5 vs. 4.3 ± 1.6 days, P No significant differences in postoperative mortality or morbidity, especially anastomotic leakage or intra-abdominal sepsis, were observed between the groups.Conclusion: Routine placement of an NG/NJT after BII and RY PDG is not necessary in elective surgery for gastric cancer.

AB - Background: Only a few, small, monocentric randomized controlled trials (RCTs) have compared routine vs. no placement of a nasogastric or nasojejunal tube decompression (NG/NJT) in patients undergoing partial distal gastrectomy (PDG) for gastric cancer. However, to our knowledge, no multicenter prospective RCT has analyzed the role of decompression after both the Billroth II (BII) procedure and Roux-en-Y (RY) gastrojejunostomy.The aim of this study was to determine whether NG/NJT prevents the consequences of postoperative ileus after PDG for gastric cancer after both BII reconstruction and RY.Methods: Two hundred seventy patients undergoing PDG for gastric cancer were randomly assigned NG/NJT placement (NG/NJT group) or not (no-NG/NJT group) with either Billroth II gastrojejunostomy or Roux-en-Y gastrojejunostomy. The patients were monitored for postoperative complications, mortality, and postoperative course.Results: By January 2010 to June 2012, among 270 patients undergoing PDG for gastric cancer, 134 were randomly assigned to NG/NJT placement (NG/NJT group) and 136 to no decompression (no-NG/NJT group). Time to passage of flatus was significantly shorter in the NG/NJT group than in the no-NG/NJT group, but only after RY reconstruction (3.3 ± 1.5 vs. 4.3 ± 1.6 days, P No significant differences in postoperative mortality or morbidity, especially anastomotic leakage or intra-abdominal sepsis, were observed between the groups.Conclusion: Routine placement of an NG/NJT after BII and RY PDG is not necessary in elective surgery for gastric cancer.

KW - Gastric cancer

KW - Gastric decompression

KW - Partial distal gastrectomy

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Naso-gastric or naso-jejunal decompression after partial distal gastrectomy for gastric cancer. Final results of a multicenter prospective randomized trial

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