Systematic review of nasogastric or nasojejunal decompression after gastrectomy for gastric cancer

Background: The aim of this meta-analysis was to evaluate the necessity of nasogastric or nasojejunal decompression after gastrectomy for gastric cancer. Methods: Medline, Embase and the Cochrane Library were searched. Only prospective randomized controlled trials (RCTs) that compared subjects with and without nasogastric or nasojejunal decompression after gastrectomy were eligible in this meta-analysis. Time to flatus, time to first oral intake, length of hospital stay, reinsertion rate, anastomotic leakage, pulmonary complications, morbidity and mortality were evaluated. Results: Eight studies finally fulfilled the inclusion criteria. This meta-analysis enrolled 1141 patients, 570 randomized to routine decompression and 571 randomized to no decompression. Time to first oral intake was significantly shorter. in the non-decompression group (WMD = 0.53,95% CI: 0.28 to 0.77; p <0.001). Additionally, subjects with nasogastric or nasojejunal decompression experienced a longer hospital stay (p = 0.001). Time to flatus, anastomotic leakage, reinsertion rates, pulmonary complications, morbidity and mortality rates were similar between the two groups. Conclusion: Nasogastric or nasojejunal decompression does not facilitate the recovery of bowel function or reduce the risk of postoperative complications. Therefore, routine nasogastric or nasojejunal decompression is unnecessary after gastrectomy for gastric cancer. (C) 2014 Elsevier Ltd. All rights reserved.