Supporting Continued Use of Nasogastric Tubes Post-Esophageal Cancer Surgery

A groundbreaking Nordic study has provided substantial evidence supporting the continued use of nasogastric (NG) tubes after esophageal cancer surgery. The research, led by Uppsala University and published in Lancet Regional Health Europe, challenges recent trends to reduce or eliminate NG tube use, demonstrating its importance in minimizing postoperative complications.

In the study, which is the largest of its kind in the Nordic region, researchers observed that patients who retained their NG tubes experienced fewer serious complications related to pressure buildup and prevented complications such as anastomotic leaks. Conversely, those who did not have the tube were at increased risk of leakage at the surgical connection site, which often necessitates urgent intervention under general anesthesia, resulting in increased patient suffering and longer hospital stays.

The procedure involves inserting a plastic tube through the nose into the stomach to decompress and reduce pressure on the surgical site. While smaller prior studies hinted that omitting the NG tube could be safe, they lacked the statistical power to influence clinical practice. This prompted a randomized trial across 12 hospitals in Sweden, Norway, Denmark, and Finland, comparing outcomes between patients with and without NG tube placement post-surgery.

Findings showed that although omitting the NG tube did not affect overall survival rates or general complications, the increase in anastomotic leaks confirmed the tube's protective role. Lead researcher Jakob Hedberg emphasized the importance of large-scale, international collaborations in conducting such studies, highlighting the trial's successful recruitment of nearly 450 patients within just over two years.

This study reinforces the importance of evidence-based practices in surgical care, suggesting that the continued use of NG tubes may be essential for patient safety. The results could influence future guidelines and standard practices for esophageal cancer surgeries, ultimately aiming to improve patient outcomes and reduce postoperative suffering.