An Randomized Controlled Study On The Size Of Stomach By Nasogastric Tube In Mc Keown Minimally Invasive Esophagectomy

Objective: To investigate the impact of nasogastric tube on the size of the stomach in McKeown minimally invasive esophagectomy(MIE)for esophageal cancer.Methods: A total of 40 patients with esophageal cancer who received McKeown minmally invasive esophagectomy were equally randomized into nasogastric tube group(NG tube group)and non-nasogastric tube group(non-NG tube group)from March to July 2018.The difference of size of stomach and dilatation at postoperative day 1,3,7,and postoperative month 1 were compared between two groups.Results:(1)There were no significant differences in age,gender,lesion location,pTNM stage,postoperative chest drainage,mediastinal drainage,Operative time,time with invasive ventilator after operation and postoperative complications between the two groups.(2)The difference of stomach size at postoperative day 1,3,7 and month 1 were statistic meaning.The size of thoracic stomach(median,quartile,unit: mm)at the 4th and 6th thoracic vertebral planes in NG group and non-NG group were 13.5(0~26.75)vs.32.5(0~52.75)(p=0.023),10(0~34.5)vs.51(0~68.50)(p=0.015)in the first postoperative day,0(0~21.75)vs.33.5(5.5~55.75)(p=0.003),0(0~35.00)vs.37(5.75~51.5)(p=0.007)in the 3rd postoperative day,20(0~25.75)vs.41.5(6.75~50.75)(p=0.004),22.5(0~43.5)vs.46.5(6.75~63.75)(p=0.024)in the 7th postoperative day and 0(0~16.5)vs.29(0~44.5(p=0.010),0(0~17.25)vs.29.8(0~52.5)(p=0.019)in the first postoperative month.(3).The difference of the stomach expansion at postoperative day 1,3,7 were statistic meaning.The chest stomach expansion occurring rate after the operation was 10% vs.50%(p=0.006)in the first postoperative day,0% vs.30%(p=0.020)in the 3rd postoperative day,15% vs.45%(p=0.038)in the 7th postoperative day and 5% vs.25%(p=0.091)in the first postoperative month.(4)The difference of the occurring rate of the chest distress after eating in the first postoperative month was statistic meaning(0% vs.30%,p=0.020).Conclusion: The nasogastric tube is beneficial to reduce the size of stomach,prevent the expansion of stomach,and improve the quality of life in McKeown MIE.