A study on the role of naso-gastric decompression in patients undergoing elective open abdominal wall hernia repair with mesh

The value of nasogastric decompression after elective open abdominal wall ventral hernia repair was studied in 60 patients - divided into 2 groups of 30 patients each, belonging to routine & selective nasogastric decompression. Nasogastric decompression was done as a compulsory measure in routine nasogastric decompression group of patients in the peri-operative period and was continued until there was onset of gastro-intestinal function. In selective nasogastric decompression group of patients, it was not practised as a routine measure, but was instituted only if and when required. This was done as there is general belief that post-operative ileus significantly increases the risk of postoperative complications including nausea, vomiting, aspiration, wound dehiscence and infection due to increased tension along the lines of wound closure, herniation, fascia adhesions, and late bowel function that may lead to a longer hospital stay. Only one patient in the selective group subsequently required decompression, due to post-operative ileus. Though increased incidence of vomiting in the selective group favoured routine nasogastric decompression,there was statistically significant increase in the complications in the routine group, such as nausea (p=0.0122), sore throat (p=0.0019) and hiccups (p=0.0237). There was also an increase in the mean hospital stay in the postoperative period among the routine group of patients, but this was considered statistically insignificant (p=0.3852). There was a single case of recurrence among both the group of patients. Hence, it is concluded that routine use of nasogastric decompression is not advocated and justified, as it serves no special advantages, but at the same time does lead to increased incidence of complications