P134 NASOGASTRIC TUBE UTILIZATION IN PATIENTS UNDERGOING ESOFAGUECTOMY: AN UNNECESSARY PROCEDURE

Abstract

Abstract Aim To evaluate the rate of complications and hospital stay length in patients undergoing esophagectomy in whom a descompressive tube was not utilized during the postoperative period. Background & Methods A descriptive and retrospective study was performed at our Health Care Center. All patients undergoing esophagectomy from March 2015 to April 2018, in which no decompressive tube was placed in the plasty during the postoperative period were included. We evaluated epidemiological variables, postsurgical morbidity -including nausea, vomiting or plasty emptying problems- postsurgical mortality, decompressive tube placement necessity and hospital stay lenght. Results A total of 41 patients were included, with an average age of 61.1 years. 82.9% were males. 43.9% were hypertensive, 63.4% were smokers and 13.1% were diabetics. 78% of patients had received neoadjuvant chemotherapy and / or radiotherapy prior to surgery. The surgical technique used was Mc Keown's esophagectomy in 23 patients (56.1%) and Ivor-Lewis tecnique in 18 (43.9%). In 85.4% of the cases, a thoracoscopic approach was used; and in 48.8% laparoscopy was utilized for abdominal approach. For the reconstruction, a gastroplasty was performed in 36 patients (87.8%) and a coloplasty was performed in 5 of them (12.2%). The anastomosis was performed manually in 53% of cases, and mechanically in 47%, by utilizing a circular stapler. The rate of complications was : 1 necrosis of the coloplasty (2,4%) who died because of a multiorganic failure; 2 stenosis of the anastomosis (4,8%) treated by endoscopic dilatations and 4 anastomosis leaks (9,8%). The mortality rate was 4,8%. 1 patient died due to coloplasty necrosis and the other one because of an acute respiratory distress syndrome (ARDS). Conclusion The non-use of a descompressive probe during the postoperative period of an esophagectomy does not entail a higher rate of complications compared to the available literature.This fact can improve the comfort of the patient and reduce hospital stay length.