BMC Surg. 2025 Nov 14;25(1):545. doi: 10.1186/s12893-025-03207-x.
ABSTRACT
OBJECTIVES: To compare outcomes of nasogastric (NGT) or nasoenteric tube decompression against no decompression in the non-operative management of adhesional small bowel obstruction (ASBO) using a systematic review and meta-analysis.
METHODS: Database searches up to February 2025 were conducted using Cochrane Library, EMBASE, MEDLINE and SCOPUS. Abstract screening and data extraction were performed by two independent reviewers. Patients aged 18 and above were included. Studies were excluded if they compared NGTs to long tube devices or if the primary aetiology of SBO was not adhesions. Quality appraisal was conducted using the Newcastle Ottawa Scale and meta-analysis was performed using RevMan Web Software.
RESULTS: Searches yielded 1442 studies, of which 4 met the inclusion criteria, comprising a total of 1219 patients undergoing non-operative management for ASBO. These were all retrospective cohort studies. Within these studies, a total of 732 patients had a nasogastric or nasoenteric tube inserted for ASBO while 487 patients were managed without one. NGT use had a non-significant trend toward increased operative intervention, with a pooled odds ratio of 2.58 (95% CI: 0.77 to 8.65; p = 0.09, I² = 82%). Three studies compared bowel resection rates; NGT use was not associated with a statistically significant increased risk of bowel resection (OR 2.31; 95% CI: 0.86-6.16; p = 0.10). All studies reported a longer length of hospital stay in the NGT group.
CONCLUSIONS: The available evidence is sparse, limited in design and quality, and marked by high heterogeneity, making it insufficient to draw a definitive conclusion regarding the role of NGTs in ASBO. High-quality evidence from a randomised controlled trial is needed to guide future practice.
TRIAL REGISTRATION: PROSPERO (CRD: CRD42021256098).
PMID:41239407 | DOI:10.1186/s12893-025-03207-x
