Meta-analysis of the need for nasogastric or nasojejunal decompression after gastrectomy for gastric cancer

Background: Nasogastric or nasojejunal decompression has been used routinely to prevent anastomotic leakage, hasten the return of bowel function and shorten hospital stay after gastrectomy for gastric cancer. This meta-analysis evaluates the necessity for such routine decompression. Methods. Medline, Embase and The Cochrane Library were searched. Only prospective randomized controlled trials (RCTs) that compared individuals with and without nasogastric or nasojejunal decompression after gastrectomy for gastric cancer were included. Outcomes evaluated were time to flatus, time to starting oral diet, anastomotic leakage, pulmonary complications, length of hospital stay, and morbidity and mortality. Results: Of 717 patients in five RCTs, 361 were allocated to nasogastric or nasojejunal decompression and 356 to no decompression. Time to oral diet was significantly shorter in the latter group (weighted mean difference 0.43 (95 per cent confidence interval 0.23 to 0.62) days; P < 0.001). Time to flatus, anastomotic leakage, pulmonary complications, length of hospital stay, morbidity and mortality were similar in both groups. Conclusion: Routine nasogastric or nasojejunal decompression is unnecessary after gastrectomy for gastric cancer.