Postoperative nasogastric decompression: a prospective randomized trial.

To determine which type of patient should receive routine postoperative nasogastric decompression (NGD), we observed 76 patients who were randomized into two groups: those who received routine NGD (n = 39) and those who received selective NGD (n = 37). Eighteen patients in the selective NGD group never required intubation, while 19 did require intubation within a mean of 3 days after surgery. In both groups, tubes remained in place for a mean of 4.7 days. The routine NGD group had a 2.5% incidence of emesis, while the selective NGD group had a 51% incidence of emesis. The return of bowel function, return to a regular diet, and postoperative length of hospital stay were similar in both groups. The patients in the selective NGD group who did not require intubation had a shorter postoperative stay. Fifty-eight percent of patients in the selective NGD group who required intubation had had major vascular or retroperitoneal dissections. These data support selective use of NGD in general surgical patients and routine use of NGD for patients having major retroperitoneal or vascular procedures.