Post-Operative Impact of Nasogastric Tubes on length of stay in infants with pyloric Stenosis (POINTS): A prospective randomized controlled pilot trial

INTRODUCTION: Postoperative emesis commonly affects infants after pyloromyotomy for pyloric stenosis. This randomized controlled trial investigates the impact of preoperative nasogastric tubes (NGTs) on postoperative emesis rate and length of stay (LOS). METHODS: Patients from January 2010 to June 2012 were screened and randomized to have an 8 French NGT or no NGT inserted prior to surgery. Patients contraindicated for NGT or pyloromyotomy, those < 6 months of age, born prematurely, or with cardiac malformations were excluded. Patient demographics, blood work, postoperative feeding, postoperative emesis rate, and postoperative LOS were collected. Student's t test and Fisher's exact test were used to compare postoperative emesis rate and LOS. RESULTS: Of 125 patients screened, 65 (52%) were eligible, and 50 (77%) were recruited. The NGT (n = 25) and no NGT (n = 25) groups had no significant difference in baseline characteristics. Postoperative emesis occurred in 17 (68%) patients with NGT compared to 12 (48%) in patients with no NGT (p = 0.25). Postoperative emesis events (52 [23%] vs. 47 [20%], p = 0.50), emesis per patient (2.08 ± 2.23 vs. 1.88 ± 2.70, p = 0.76 95% CI: -1.21 to 1.61), and LOS (34.77 ± 13.74 vs. 36.33 ± 19.36, p = 0.74 95% CI: -11.11 to 7.98) were similar between NGT and no NGT groups. CONCLUSION: Preoperative NGT insertion had no demonstrable effect on LOS or postoperative emesis rate after pyloromyotomy.