Dispensability of nasogastric tube after perforated peptic ulcer surgery: a randomized controlled trial

Abstract

Introduction Every year, approximately 4 million individuals are affected by peptic ulcer disease (PUD). Among patients with PUD, the lifetime occurrence of perforation stands at ∼5%. Associated with this complication is a mortality rate spanning from 1.3 to 30%. Whether the surgery was done open or laparoscopic, the postoperative plan of management remained dogmatic for many years, especially regarding the presence of a nasogastric (NG) tube. Patients and methods This prospective, single-center, randomized controlled study of patients with perforated peptic ulcer (PPU) presented to Kasr Alainy Emergency Hospital was conducted to assess the dispensability of NG tube postoperatively in perforated peptic ulcer patients. Patients were randomly allocated into two groups, group A (NG tube control group): 40 patients and group B [Enhanced Recovery after Surgery (ERAS) group]: 34 patients. Results The study revealed a significant decrease in hospital stay by approximately 2 days for patients in the ERAS group, compared with those receiving standard care. This reduction in hospital stay was observed without any increase in postoperative complications among the ERAS group. However, this may be clinically nonsignificant due to a limited number of patients in our study. Conclusion The routine use of NG decompression and delayed oral feeding appears to be unnecessary. These practices contribute to prolonged hospital stays without yielding any beneficial effects on morbidity and mortality rates.