One-day nasogastric tube decompression after distal gastrectomy: a prospective randomized study

One-day nasogastric tube decompression after distal gastrectomy: a prospective randomized study Surg Today (2018) 48:127 LETTER TO THE EDITOR One‑day nasogastric tube decompression after distal gastrectomy: a prospective randomized study 1 2 Alberto Mangano  · Laura Marciano   Received: 15 May 2017 / Accepted: 5 June 2017 / Published online: 19 July 2017 © Springer Japan KK 2017 Keywords Distal gastrectomy · Nasogastric tube · conducted, it is essential to preliminarily establish the num- Evidence based surgery · Randomized controlled trial ber of individuals needed to reach sufficient statistical power. In particular, the sample size calculation is influenced by the frequency of occurrence of the phenomenon we want to Sir, test; that is, the lower the occurrence, the larger the sample We do appreciate the aim of the prospective, randomized trial size needed to achieve sufficient statistical power. Moreover, conducted by Kimura et  al. [1], to assess whether standard the sequence allocation method was not specified and this is 1-day nasogastric tube (NGT) decompression is an avoidable another relevant element that must be mentioned when per- step in distal gastrectomy. De facto, distal gastrectomy is a forming a randomized trial [2]. When a new approach or common operation, particularly in Asia, with a not uncom- surgical technique (or variation of a pre-existing protocol) is mon complication rate. Hence, we read this valuable manu- introduced, it is important that it is accurately standardized script with extreme interest. We agree with the authors that to achieve reproducible results among different centers [ 3]. at this stage, the scientific literature has not clarified whether Hence, it would be interesting to conduct additional prospec- the uncomfortable procedure of 1-day NGT placement is of tive multicenter trials in the same area to confirm the authors’ clinical benefit in preventing postoperative complications. interesting conclusions and add further robust and statisti- For this reason, if the aforementioned question is answered, cally based data. we could theoretically avoid inflicting the discomfort of NGT Again, we thank our colleagues for their strong contribu- decompression on patients undergoing distal gastrectomy. In tion toward a better understanding of this topic. their conclusion, our colleagues claim that there were no sig- Compliance with ethical standards nificant postoperative complications or postoperative course recovery differences between the NGT and non-NGT arms Conflict of interest The authors declare that they have no competing of their series. However, despite using appropriate statisti- interests. cal tests, it does not seem that they have calculated a pre-hoc sample size. In other words, whenever a prospective study is References 1. Kimura Y, Yano H, Iwazawa T, Fujita J, Fujita S, Yamamoto K, Yasuda T. One-day nasogastric tube decompression after distal This comment refers to the article available at gastrectomy: a prospective randomized study. Surg Today. 2017. doi:10.1007/s00595-017-1475-0. doi:10.1007/s00595-017-1475-0. 2. Dettori J. The random allocation process: two things you need to * Alberto Mangano know. Evid Based Spine Care J. 2010;1(03):7–9. 3. Mangano A, Rausei S, Lianos GD, Dionigi G. Quality of life after gastrectomy for adenocarcinoma: a prospective cohort Via Mulini 12, 22015 Gravedona ed Uniti (Como), Italy study. Ann Surg. 2015;262(6):e110. University Center of Statistics for the Biomedical Sciences, Vita-Salute San Raffaele University, Via Olgettina 58, 20132 Milan, Italy Vol.:(0123456789) 1 3 Surgery Today Springer Journals

One-day nasogastric tube decompression after distal gastrectomy: a prospective randomized study

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Medicine & Public Health; Surgery; Surgical Oncology
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