Nasogastric- vs. percutaneous gastrostomy tube for prophylactic gastric decompression after cytoreductive surgery with hyperthermic intraperitoneal chemotherapy.
cytoreductive surgery (CRS)
gastric decompression
hyperthermic intraperitoneal chemotherapy (HIPEC)
length of stay (LOS)
nasogastric tube
percutaneous gastrostomy
postoperative outcomes
Journal
Pleura and peritoneum
ISSN: 2364-768X
Titre abrégé: Pleura Peritoneum
Pays: Germany
ID NLM: 101710063
Informations de publication
Date de publication:
Jun 2021
Jun 2021
Historique:
received:
15
01
2021
accepted:
25
02
2021
entrez:
28
6
2021
pubmed:
29
6
2021
medline:
29
6
2021
Statut:
epublish
Résumé
Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) is associated with postoperative gastroparesis and ileus. In 2015, our practice shifted from using percutaneous gastrostomy tubes (PGT), to nasogastric tubes (NGT) for prophylactic gastric decompression after CRS-HIPEC. This study aimed to compare these methods for length of stay (LOS) and associated complications. Patients that underwent CRS-HIPEC for peritoneal metastases from colorectal cancer between 2014 and 2019 were included. Cases were grouped based on receiving NGT or PGT postoperatively. Multivariable linear regression determined the independent effect of decompression method on LOS, thereby adjusting for confounders. In total, 179 patients were included in the analyses. Median age was 64 years [IQR:54-71]. Altogether, 135 (75.4%) received a NGT and 44 (24.6%) received a PGT. Gastroparesis occurred significantly more often in the PGT group (18.2 vs. 7.4%, p=0.039). Median LOS was significantly shorter for patients with a NGT (15 [IQR:12-19] vs. 18.5 [IQR:17-25.5], p<0.001). PGT was independently associated with longer LOS in multivariable analysis (Beta=4.224 [95%CI 1.243-7.204]). There was no difference regarding aspiration, pneumonia and postoperative mortality between groups. NGT should be preferred over PGT for gastric decompression after CRS-HIPEC as it is associated with fewer gastroparesis and shorter LOS.
Identifiants
pubmed: 34179339
doi: 10.1515/pp-2021-0107
pii: pp-2021-0107
pmc: PMC8216841
doi:
Types de publication
Journal Article
Langues
eng
Pagination
57-65Informations de copyright
© 2021 Job P. van Kooten et al., published by De Gruyter, Berlin/Boston.
Déclaration de conflit d'intérêts
Competing interests: Authors state no conflict of interest.
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