Evaluation of the Necessity of Nasogastric Tube in Gastric Surgery: A Comparative Study in a Tertiary Care Hospital in Bangladesh

Background: The routine use of nasogastric (NG) tubes in gastric surgery remains controversial. Although NG tubes are traditionally employed to prevent postoperative complications, their necessity has been questioned due to potential discomfort and adverse effects. This study aimed to assess the necessity of NG tube placement by comparing postoperative outcomes between patients with NG tubes (intubated) and those without (tubeless). Methods: This quasi-experimental study was conducted at the Department of General Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh, from October 2023 to September 2024. A total of 60 patients who underwent gastric surgery for malignant and benign conditions were enrolled and randomly assigned to two groups: Group I (intubated, n=30) and Group II (tubeless, n=30). All patients received epidural pain control. Key parameters included preoperative serum albumin levels, postoperative complications, time to passage of stools, time to first oral feeding, length of hospital stay, and hospitalization costs. Statistical analysis was performed using SPSS version 22.0. Results: Group I (intubated) had significantly longer times for bowel sound return (88.01 ± 20.17 hours vs. 76.5 ± 21.87 hours, p = 0.038), bowel movement (119.28 ± 23.81 hours vs. 95.07 ± 25.67 hours, p = 0.004), and oral resumption (118 ± 24.27 hours vs. 105.52 ± 22.99 hours, p = 0.045). Pulmonary complications were more common in Group I (33.3%) than in Group II (3.3%, p = 0.002). The mean hospital stay was shorter in Group II (7.76 ± 1.98 days) compared to Group I (9.55 ± 2.19 days, p = 0.001). Conclusion: The study demonstrates that omitting nasogastric tubes in gastric surgery results in faster recovery, fewer complications, and reduced hospital stay. These findings suggest a tubeless approach may be advantageous, particularly in improving recovery times and minimizing pulmonary complications.