Background: Despite an introduction of more successful pharmacological treatment of peptic ulcer disease, the frequency of ulcer perforation, its main complication, has not decreased. Perforation of an ulceration is a state of emergency which requires urgent operation. For nearly a hundred years, the application of a nasogastric tube and leaving it in during the postoperative period has been a part of the standard medicinal procedure. At the same time, reports which have appeared in the last decade suggest that there is no need to leave a nasogastric tube in during the postoperative period, if such necessity does not exist. This work presents an attempt to answer the question whether it is necessary to maintain a nasogastric tube in patients undergoing operation due to ulcer perforation.
Material and methods: During the years 2004-2007, 61 patients (19 women and 42 men) aged from 15-86 years (mean 52.35) underwent an operation because of perforation of the gastrointestinal tract. Before the surgical procedure a nasogastric intubation was performed. The tube was left in until gastrointestinal functions had returned (from 2 to 11 days, an average of 4.1 days). In order to assess the possible impact of nasogastric intubation on postsurgical complications during the postoperative period, the capacity of nasogastric contents and the number of deaths were evaluated.
Results: 63% of nasogastric tubes were removed on the 3rd and 4th postoperative day. Postoperative complications related to alimentary tract perforation or the surgically-performed procedure were observed in 5 cases (8.1%). Among observed postoperative complications, wound suppuration, eventration and anastomosis dehiscence took place during the time when a nasogastric tube was maintained in all patients.
Conclusions: The application of a nasogastric tube has a limited influence on postoperative complication prevention in patients undergoing surgical treatment due to gastro-duodenal perforation. It is necessary to further investigate this issue to find the group of patients presenting the greatest benefits related to nasogastric tube maintenance after such surgical procedures.