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The Usefulness of Intraoperative Needle Decompression of the Colon during Radical Gastrectomy -A Prospective and Randomized Trial-

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¹Ú¼º¿­(Park Sung-Yeol) - µ¿¾Æ´ëÇб³ ÀÇ°ú´ëÇÐ ¿Ü°úÇб³½Ç
±è¹ÎÂù(Kim Min-Chan) - µ¿¾Æ´ëÇб³ ÀÇ°ú´ëÇÐ ¿Ü°úÇб³½Ç
±è±âÇÑ(Kim Ki-Han) - µ¿¾Æ´ëÇб³ ÀÇ°ú´ëÇÐ ¿Ü°úÇб³½Ç
±èÁ¤¹Î(Kim Jung-Min) - µ¿¾Æ´ëÇб³ ÀÇ°ú´ëÇÐ ¿Ü°úÇб³½Ç
±è¼ºÈç(Kim Sung-Heun) - µ¿¾Æ´ëÇб³ ÀÇ°ú´ëÇÐ ¿Ü°úÇб³½Ç
ÃÖÈ«Á¶(Choi Hong-Jo) - µ¿¾Æ´ëÇб³ ÀÇ°ú´ëÇÐ ¿Ü°úÇб³½Ç
±è¿µÈÆ(Kim Young-Hoon) - µ¿¾Æ´ëÇб³ ÀÇ°ú´ëÇÐ ¿Ü°úÇб³½Ç
Á¶¼¼Çå(Joh Se-Heon) - µ¿¾Æ´ëÇб³ ÀÇ°ú´ëÇÐ ¿Ü°úÇб³½Ç
Á¤°©Áß(Jung Ghap-Joong) - µ¿¾Æ´ëÇб³ ÀÇ°ú´ëÇÐ ¿Ü°úÇб³½Ç

Abstract

Purpose :Intraoperative colonic distension is associated with postoperative ileus, which contributes to a delayed hospital discharge. A randomized and prospective study was conducted to evaluate the usefulness of intraoperative needle decompression of the colon (IDC) during a radical gastrectomy for gastric cancer.

Methods :Fifty patients that had received subtotal or total gastrectomy for gastric cancer were randomly assigned to either a non-decompression (n=27) or a decompression group (n=23). Prior to the main procedure, the transverse or right colon was pulled up, and a 19-gauge disposable needle connected to suction was introduced to the colon through the taenia site of the anterior wall. Any gas that collected in the colon was aspirated. The time to the first postoperative passage of flatus or feces was measured precisely in order to evaluate the restoration of bowel function. Additional measures of the outcome were the operation time, the complication rate and the length of hospital stay.

Results :Demographic details, pathologic features, operation times, complication rates and the length of hospital stay were not different between the two groups. A collapsed colon was required for good surgical exposure and easy manipulation. No unexpected complications related to the procedure were found. The average time to the first flatus was 6.8 hours sooner in the decompression group than in the non-decompression, although this result was not statistically significant.

Conclusion :This technique is a simple and safe procedure for intraoperative colon decompression during a radical gastrectomy.

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Gastric cancer, Randomized prospective trial, Needle decompression, First flatus time,
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Demographic details, pathologic features, operation times, complication rates and the length of hospital stay were not different between the two groups.
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