The Necessity Of Indwelling Gastric Tube Before The Radical Resection Of Bladder Ileum Channel

Objective:To evaluate the needs for prophylactic nasogastric decompression before radical cystectomy and ileal cystoplasty.Methods:This retrospective study included 81 patients who underwent radical cystectomy and ileal cystoplasty at Guizhou Province People’s hospital from January 2005 to October 2014.These patients were separated into group A(21 patients without nasogastric decompression) and group B(60 patients with prophylactic nasogastric decompression ahead of surgery). Operation time,amount of bleeding,the time of wound healing,out of bed and anal exhaust together with incidence of pulmonary infection,intestinal obstruction, electrolyte disturbances,indwelling gastric tube again after operation,scores in comfort were recorded and compared between the two groups.Result:All the patients in this study were cured and discharged.Shorter operation time in group A(333.4±16.1 min) made the difference in opreation time was statistically significant,compared with Group B(395.2±13.5 min)(P<0.05).The amount of bleeding during surgery in groups were 1140.0±145.2(200-2600)ml and 1195.3±142.8(200-3000)ml respectively.The time of anal exhaust in these groups were 4.0±0.39(2-9)d and4.7±0.32(1-16)d, that of wound healing 15±1.27(9-24)d and 19.52±2.52(9-56)d. These differences had no statistics significance(P>0.05).However,that out of bed were 4.8±0.61(2-9)d and 8.56±0.62(3-26)d separately which showed statistical significance. Statistical difference,14.67±1.42(8-29)d and 27.33±3.32(10-45)d,also represented in postoperative length of stay between the two groups.Of all the patients,2 cases had pulmonary infection in each group.2 in Group A and 8 cases in Group B had intestinal obstruction, 3 in Group A and 6 patients in Group B received postoperative nasogastric decompression.3 in Group A and 13 in Group B had electrolyte disturbances.In this regard,no significant statistical difference between the two groups. Scores in comfort of two groups were 36.2±6.6(28-51)and 46.0±8.3(38-60)which appeared to be statically significant(P<0.05).Conclusion:Preoperative nasogastric decompression can not lessen the postoperative complications,but could prolong patient’s length of stay, delay the time point of out of bed and aggravate discomfort.