“The prophylactic use of nasogastric tubes after abdominal operations, flexible tubes inserted through the nose, pharynx, oesophagus and into the stomach, has happened only in the last century, becoming so prevalent that it has been variously described as “the standard of care” (Montgomery 1996), “traditionally used by most surgeons” (Lee 2002), “common practice” (Cunningham 1992, Sakadamis 1999, Manning 2001), “unquestioned” (Savassi-Rocha 1992), and “routine” (Wolff 1989). What is to be achieved by this prophylaxis is gastric decompression, decreased likelihood of nausea and vomiting, decreased distention, less chance of pulmonary aspiration and pneumonia, less chance of wound separation and infection, less chance of fascial dehiscence and hernia, earlier return of bowel function, and earlier hospital discharge.”

Implications for practice
“Prophylactic nasogastric decompression following abdominal operations was undertaken with the intent of:

1 Hastening return of bowel function

2 By emptying the stomach, easing respiration and diminishing the
risk of aspiration of gastric contents and therefore decreasing the
risk of pulmonary complications

3 Increasing patient comfort, by lessening abdominal distension

4 Protect intestinal anastomoses and prevent anastomotic leakage

5 Shortening hospital stay

This review has shown that the intervention is ineffective in achieving any of these goals, and in fact significant benefit may be obtained by avoidance of prolonged intubation and only selective tube insertion when needed to relieve gastric symptoms.
Wound infection (and one of its most common sequellae, incisional hernia (may be more common when routine intubation is avoided.) The reasons for this are not clear.
Many surgeons already avoid routine intubation. Those that don’t, probably should.”

Nelson, R et al. “Prophylactic nasogastric decompression after abdominal surgery.” The Cochrane database of systematic reviews vol. 2007,3 CD004929. 18 Jul. 2007 Free Full Text