Hypertrophic Pyloric Stenosis: Why Are We Still Using a Nasogastric Tube at Diagnosis

Résumé fourni par la source

Abstract Purpose: In patients presenting with hypertrophic pyloric stenosis, the placement of a nasogastric tube (NGT) before surgery is supposed to prevent the aspiration of gastric fluid into the lungs. The objective of the present study was to determine whether or not a NGT prevents respiratory complications. Methods: A cohort of 87 patients from a prospectively maintained database were retrospectively included in the study; we compared patients with vs. without NGT placement before surgery. The primary endpoint was the occurrence of respiratory complications. Results: Three patients (two patients in the no-NGT group and one in the NGT group) presented severe respiratory complications; even though there was no evidence of lung aspiration, these adverse events obliged us to discontinue the study.There were no differences between the NGT and no-NGT groups with regard to the time to correction of the electrolyte imbalance, the time to complete oral refeeding, the length of hospital stay, and the incidence of other complications. The level of pre-operative discomfort appeared to be higher in the NGT group. Conclusion: In patients with hypertrophic pyloric stenosis, avoiding pre-operative NGT placement is potentially unsafe in some circumstances. Although our results did not argue in favor of NGT placement overall, more evidence is required.

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