Application research of timing of removal of the nasogastric tube after laparoscopic assisted Hirschsprung's radical operation in children

Objective To evaluate the safety and feasibility of removing nasogastric tube in children after laparoscopic assisted Hirschsprung's radical operation. Methods From February 2018 to February 2019, 60 children in the Children's Hospital affiliated to Capital Institute of Pediatrics diagnosed with short-segment and common type of Hirschsprung's disease and undergoing laparoscopic assisted radical operation were selected. The children were divided into study group(n=30) and control group(n=30) according to the random number table after entering the operating room. In the study group, the nasogastric tube was removed immediately after recovery of anesthesia, while in the control group, the nasogastric tube was left in place after surgery until the patient passed stool. General information, operative time, postoperative first dejection time, abdominal perimeter(prior to surgery, end of surgery, 24-hour and 48-hour post-surgery), frequency of vomiting, time to start of water and food intake, length of postoperative hospital stay, cost of hospitalization, and pediatric anesthesia emergence delirium(PAED) 30-minutes after surgery were compared between the two groups. Results The gender structure, age[5.5(3.0, 23.2) vs. 6.5(3.0, 19.5) months)], weight[(8.6±3.1) kg vs.(9.1±2.3) kg], operative time[107(97, 118) vs. 110(99, 130) min], time to start of food intake[64(52, 74) vs. 75(52, 84)], and postoperative first dejection time[24(20, 33) h vs. 25(15, 40) h] were not significantly different between the two groups(all P>0.05). Compared with control group, PAED 30-minutes after surgery[5.0(5.0, 5.0) vs. 7.0(5.0, 10.0)], frequency of vomiting[4(13%) vs. 13(43%)], time to start of water intake[30(20, 48) h vs. 48(35, 71) h], length of postoperative hospital stay[6.0(5.0, 7.0) vs. 6.6(5.6, 9.6) days], and cost of hospitalization[3.4(2.4, 3.7) vs. 4.0(3.0, 4.3)] were significantly decreased in the study group(all P<0.05). The abdominal perimeter 24-hour post-surgery was significantly higher in the study group than that in the control group(P<0.05). Conclusion Removal of nasogastric tube in children with short-segment and common type of Hirschsprung's disease after laparoscopic assisted radical operation is safe and feasible, which can improve comfort level, enhance recovery and improve clinical nursing quality.