PD1069 - ACTUAL USE OF NASOGASTRIC TUBES FOR DECOMPRESSION OF GASTRIC CONTENT IN PATIENTS AFTER MAJOR ABDOMINAL GASTRO-INTESTINAL SURGERY: RETROSPECTIVE ANALYSIS OF REAL-WORLD DATA

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PD1069

ACTUAL USE OF NASOGASTRIC TUBES FOR DECOMPRESSION OF GASTRIC CONTENT IN PATIENTS AFTER MAJOR ABDOMINAL GASTRO-INTESTINAL SURGERY: RETROSPECTIVE ANALYSIS OF REAL-WORLD DATA

H. H. Van Noort1,*, R. Postmus-Jellema2,3, G. Huisman-de Waal4, M. W. Stommel1

1Department of Surgery, Radboud university medical centre, 2Department of Surgery, Radboudumc, Nijmegen, 3Department of Surgery, Isala, Zwolle, 4IQ health, Radboud university medical centre, Nijmegen, Netherlands

 

Rationale: Recovery after gastrointestinal surgery can be compromised by postoperative gastrointestinal dysfunction (POGD), including delayed gastric emptying (DGE) or ileus. POGD requires a nasogastric tube (NGT) for decompression of gastric residual content. This study aimed to analyse the actual use of NGTs in patients after major gastrointestinal surgery.

Methods: Real-world data from patients undergoing major gastrointestinal surgery in 2022 and 2023 were retrospectively analysed. Data of patients recovering from colon, rectal, liver, pancreatic, and cytoreductive surgery were assessed from electronic medical files (EMF). Outcomes included the number of inserted NGT’s per patient, length of tube use, need for re-insertion, and decompressed volume. NGT's were eligble if at least 12 french and inserted for decompression. Length of tube use was compared with DGE grades involving duration of DGE (A= 4-7 days; B= 8-14 days, C= >14 days).

Results: 289 NGTs were placed in 208 (53%) of 393 included patients, with high use in patients after pancreatic (n=105, 85%) and cytoreductive surgery (n=45, 98%). One NGT was used in 152 (73%) patients, which was removed after maximal 2 days in 101 (49%) patients. NGT’s were re-inserted in 56 (27%) patients, once in 38 and twice in 13 patients. Median length of tube use of all NGT-insertions was 12 days (IQR 7-16.5). Length of tube use did not meet DGE-grades in 120 (58%) patients, and did meet DGE-grade B/C in 48 (23%) patients.

Conclusion: Frequent NGT-use after major gastrointestinal surgical procedures was shorter than DGE-grades in about half of the patients receiving one. In others, re-insertion was required after early removal. Clinicians must be enabled to distinguish patients between normal or delayed bowel recovery for optimal NGT use and timely nutritional treatment.

Disclosure of Interest: None declared