• Aurélien Venara, Jean-Francois Hamel, Eddy Cotte, Hélène Meillat, Pierre-Yves Sage, Karem Slim, and GRACE Group*.
• Department of Visceral and Endocrinal Surgery, CHU Angers, University Hospital of Angers, 4, rue Larrey, 49933, Angers Cedex 9, France. auvenara@yahoo.fr.
• Surg Endosc. 2020 Dec 1; 34 (12): 5583-5592.

BackgroundAvoiding the use of nasogastric tubes (NGTs) is recommended after colorectal surgery but there is no consensus on intraoperative gastric decompression using NGTs during colorectal surgery. The objective was to assess the effect of avoiding insertion of NGTs during colorectal surgery for the recovery of gastrointestinal (GI) functions.Method1561 patients undergoing colorectal surgery, for whom information on NGT use was available, were included in this retrospective analysis and propensity score analysis of the prospective GRACE Audit database. Patients who did and did not have an NGT during surgery were compared.ResultsAmong the study population of 1561 patients, 696 patients were matched to correct baseline differences between groups. The no-NGT group significantly improved GI motility impairment (e.g., less postoperative nausea [OR = 0.59; CI 95%: 0.42-0.84] and a better tolerance of early feeding [OR = 2.07; CI 95%: 1.33-3.22]). Such an association was also highlighted for reduced postoperative morbidity [OR = 0.60; CI 95%: 0.43-0.83], and especially pulmonary complications [OR = 0.08; CI 95%: 0.01-0.59], or parietal complications [OR = 0.29; CI 95%: 0.09-0.87]. The risk of postoperative ileus was not significantly reduced in the no-NGT group [OR = 0.67; CI 95%: 0.43-1.06].ConclusionNo NGT insertion during colorectal surgery is safe and could improve postoperative GI function recovery.

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