Nasogastric tube decompression is unnecessary in patients undergoing laparoscopic nephroureterectomy for localized upper tract urothelial carcinoma

Fu-Shun Hsu; Wei-Yi Huang; Yu-Fen Chen; Ling-Ying Wu; Suo-Meng Wang; Kuo-How Huang

doi:10.1016/j.jfma.2019.11.011

Nasogastric tube decompression is unnecessary in patients undergoing laparoscopic nephroureterectomy for localized upper tract urothelial carcinoma

J Formos Med Assoc. 2020 Sep;119(9):1353-1359. doi: 10.1016/j.jfma.2019.11.011. Epub 2019 Dec 5.

Authors

Fu-Shun Hsu¹, Wei-Yi Huang², Yu-Fen Chen³, Ling-Ying Wu⁴, Suo-Meng Wang⁵, Kuo-How Huang⁶

Affiliations

¹ Department of Urology, Heping Fuyou Branch, Taipei City Hospital, Taipei, Taiwan; Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan.
² Institute of Health and Welfare Policy, National Yang-Ming University, Taipei, Taiwan; Department of Healthcare and Medical Care, Veterans Affairs Council, Taipei, Taiwan.
³ Department of Nursing, Kang-Ning Junior College of Medical Care and Management, Taipei, Taiwan.
⁴ Graduate Institute of European Studies, Tamkang University, Taipei, Taiwan; Ministry of Health and Welfare, Taipei, Taiwan.
⁵ Department of Urology, National Taiwan University Hospital, Taipei, Taiwan.
⁶ Department of Urology, National Taiwan University Hospital, Taipei, Taiwan; Department of Urology, College of Medicine, National Taiwan University, Taipei, Taiwan. Electronic address: khhuang123@ntu.edu.tw.

PMID: 31813657
DOI: 10.1016/j.jfma.2019.11.011

Abstract

Background/purpose: This study investigates the safety and feasibility to perform laparoscopic nephroureterectomy (LNU) for upper tract urothelial carcinoma (UTUC) without routine nasogastric tube (NGT) decompression.

Methods: The hospital-based samples comprised of 100 consecutive UTUC patients receiving elective LNU performed by two experienced surgeons. The nationwide data was based on LHID2005 composed of one million beneficiaries randomly selected from the Taiwan National Health Insurance Research Database to identify patients with the diagnoses of UTUCs receiving LNUs. We then compared baseline characteristics, peri-operative data, convalescence parameters and complications between two groups stratified by use of NGT tube.

Results: The hospital-based samples composed of 50 subjects with NGT and 50 without. There were no significant differences in baseline characteristics between two groups. Peri-operative and convalescence parameters were similar when comparing no NGT versus NGT: blood loss of 206 vs. 165 mL; operative time of 180.5 vs.181.1 min; days to intake was 2.1 vs.1.7 days; and hospital stay of 7.8 vs. 7.5 days (all p > 0.05). The nationwide study samples comprised 140 subjects, of which 72 were with NGT and 68 were with no NGT. The baseline data, complications and length of hospital stay were similar between two groups.

Conclusion: Surgery-naïve patients with localized UTUC received LNU without peri-operative NGT is safe and feasible.

Keywords: Laparoscopic nephroureterectomy; Nasogastric tube; Upper tract urothelial carcinoma.

MeSH terms

Carcinoma, Transitional Cell* / surgery
Decompression*
Humans
Intubation, Gastrointestinal*
Laparoscopy*
Nephroureterectomy*
Taiwan / epidemiology
Treatment Outcome