Surgeons routinely use nasogastric (NG) tubes in most esophageal resection surgeries. Considering the numerous complications caused by using the tube and the uncertainty about its usefulness and the scarcity of studies conducted on the subject, particularly in patients with esophageal cancer, the necessity of using the tube in these types of cases is investigated in the present study. In this clinical trial, patients with esophageal cancer were randomized into groups with NG tube and without NG tube after surgery; the latter were prescribed Metoclopramide, as well. The variables recorded for each patient included the first day of gas passage, defecation and bowel sounds (BSs) auscultation, as well as the duration of postoperative hospitalization, nausea and vomiting, abdominal distension, pulmonary complications, wound complications, anastomosis leak, and the need for placing/replacing the NG tube. The incidence of anastomosis leak was significantly higher in the NG-tube group (6 vs. 0; P = 0.016). Other complications were not different in the two groups. The mean time of gas passage, defecation, BS auscultation, and the duration of postoperative hospitalization did not have meaningful differences in the two groups. The need for placing/replacing the NG tube was the same for both groups. The routine application of NG tubes after surgery is not recommended for all patients. We suggest that NG tubes should be used according to the specific problems of each patient.

Omission of Nasogastric Tube Application in Postoperative Care of Esophagectomy

Enhanced Recovery After Gastrointestinal Surgery (ERAS) in Pediatric Patients: a Systematic Review and Meta-analysis.

BACKGROUND : Health care workers (HCWs) are prone to occupational accidents and injuries such as needle pricks in the course of their day to day activities in the health care setting. OBJECTIVE : To determine the prevalence of needle sticks and other occupational exposures among HCWs in a Nigerian tertiary hospital. METHODS : This was a descriptive cross sectional design involving all the doctors, and all laboratory workers and a selection of nurses. A structured, pre-tested, selfadministered questionnaire was the tool for data collection. RESULTS : A total of 167 HCWs made up of 47 (28.1%) doctors, 100 (59.9%) nurses and 20 (12.0%) laboratory workers were interviewed. Twenty -five (53.2%) doctors, 53 (53.0%) nurses and 10 (50.0%)  laboratory workers making a total of 88 (52.7%) HCWs had had needle pricks, while 28 (59.6%) doctors, 53 (53.0%) nurses and 8 (40.0%)  laboratory workers making a total of 89 (53.3%) have had blood splashes. A higher proportion of nurses 54 (54.0%) had cuts from drug ampoules than doctors (34.0%) while 16 (36.2%) doctors had glove perforation during surgery compared to nine (9.0%) nurses. Only 43 (25.7%) HCWs reported to the staff clinic after sustaining accidents/injuries. CONCLUSION : The prevalence of needle sticks and other occupational accidents/injuries among HCWs in the Federal Medical Centre, Asaba, Nigeria is high. There is also a high rate of non-reporting of these injuries to relevant authorities. All health facilities should have a written injection safety policy and a post-exposure protocol and HCWs should be continually educated on them. WAJM 2012; 31(1): 47–51. Keywords : Needle sticks, accidents/injuries, health care workers, Federal Medical Centre.

/pdf/prevalence-of-occupational-accidents-injuries-among-health-34v7mpvdf2.pdf

Prevalence of occupational accidents/Injuries among health care workers in a federal medical centre in southern Nigeria.

Enhanced recovery after surgery in paediatrics: a review of the literature.

Does Routine Nasogastric Tube Placement After an Operation for Perforated Appendicitis Make a Difference

The purpose of this study was to evaluate the role of nasogastric (NG) decompression after laparotomy in pediatric surgical practice: 94 children who underwent abdominal surgery by a single surgeon were consecutively prospectively managed without postoperative NG tubes. Patients with either bowel obstruction or intra-abdominal infection were excluded from the study. These children were compared with 94 retrospective, matched controls who were routinely managed with postoperative NG decompression by the same surgeon. Data were analyzed with regard to patient, operative, and outcome variables. There was no difference in gender, age (3.8 ± 0.5 vs 3.5 ± 0.4 years, P > 0.7), or postoperative complications (P > 0.8) between the two groups. However, there was a higher incidence of postoperative vomiting (22% vs 11%, P > 0.05) in the children who did not have postoperative NG decompression. Nevertheless, a significant decrease in time to first feed, first stool, and discharge was noted in the group of patients managed without NG tubes (P < 0.05). NG decompression thus need not be routinely used in the pediatric patient undergoing abdominal surgery, as there is no difference in postoperative complications and the hospital stay is shortened.

To tube or not to tube: do infants and children need post-laparotomy gastric decompression?

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To tube or not to tube: do infants and children need post-laparotomy gastric decompression?