Observational Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Oncol. Mar 24, 2024; 15(3): 411-418
Published online Mar 24, 2024. doi: 10.5306/wjco.v15.i3.411
Clinical application of reserved gastric tube in neuroendoscopic endonasal surgery for pituitary tumor
Xi Chen, Long-Yao Zhang, Zhi-Feng Wang, Yi Zhang, Yu-Hua Yin, Xue-Jian Wang
Xi Chen, Department of Nursing, Affiliated Hospital 2 of Nantong University, Nantong 226000, Jiangsu Province, China
Long-Yao Zhang, Zhi-Feng Wang, Yi Zhang, Xue-Jian Wang, Department of Neurosurgery, Affiliated Hospital 2 of Nantong University, Nantong 226000, Jiangsu Province, China
Yu-Hua Yin, Department of Neurosurgery, Renji Hospital, Shanghai Jiao Tong University, Shanghai 226000, China
Co-first authors: Xi Chen and Long-Yao Zhang.
Author contributions: Chen X, Wang XJ, and Yin YH treated all these patients; Zhang Y and Wang ZF collected the data; Chen X and Zhang LY analyzed the data; Wang XJ wrote the manuscript, Zhang LY and Wang XJ revised and checked this article; All authors contributed to the article and approved the submitted version.
Supported by Traditional Chinese Medicine Science and Technology Project in Jiangsu Province, No. YB2015113; the Science and Technology Program of Nantong Health Committee, No. MA2019003, No. MA2021017, No. MB2021026, and No. MB2021027; Science and Technology Program of Nantong City, No. Key003, No. MS12015016 and No. JCZ2022040; and Kangda College of Nanjing Medical University, No. KD2021JYYJYB025, No. KD2022KYJJZD019, No. KD2022KYJJZD022, and No. 2023ZC127.
Institutional review board statement: This research has been approved by the ethics committee of Affiliated Hospital 2 of Nantong University.
Informed consent statement: Informed consent has been obtained and this investigation has been conducted according to the principles expressed in the Declaration of Helsinki.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The original contributions presented in the study are included in the article, further inquiries can be directed to the corresponding author at 6841441@163.com.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xue-Jian Wang, MD, PhD, Professor, Surgeon, Department of Neurosurgery, Affiliated Hospital 2 of Nantong University, No. 666 Shengli Road, Chongchuan District, Nantong 226000, Jiangsu Province, China. 6841441@163.com
Received: October 28, 2023
Peer-review started: October 28, 2023
First decision: January 12, 2024
Revised: January 19, 2024
Accepted: February 27, 2024
Article in press: February 27, 2024
Published online: March 24, 2024
Abstract
BACKGROUND

The neuroendoscopic approach has the advantages of a clear operative field, convenient tumor removal, and less damage, and is the development direction of modern neurosurgery. At present, transnasal surgery for sphenoidal pituitary tumor is widely used. But it has been found in clinical practice that some patients with this type of surgery may experience post-operative nausea and vomiting and other discomforts.

AIM

To explore the effect of reserved gastric tube application in the neuroendoscopic endonasal resection of pituitary tumors.

METHODS

A total of 60 patients who underwent pituitary adenoma resection via the endoscopic endonasal approach were selected and randomly divided into the experimental and control groups, with 30 in each group. Experimental group: After anesthesia, a gastric tube was placed through the mouth under direct vision using a visual laryngoscope, and the fluid accumulated in the oropharynx was suctioned intermittently with low negative pressure throughout the whole process after nasal disinfection, during the operation, and when the patient recovered from anesthesia. Control group: Given the routine intraoperative care, no gastric tube was left. The number of cases of nausea/vomiting/aspiration within 24 h post-operation was counted and compared between the two groups; the scores of pharyngalgia after waking up, 6 h post-operation, and 24 h post-operation. The frequency of postoperative cerebrospinal fluid leakage and intracranial infection were compared. The hospitalization days of the two groups were statistically compared.

RESULTS

The times of postoperative nausea and vomiting in the experimental group were lower than that in the control group, and the difference in the incidence of nausea was statistically significant (P < 0.05). After the patient woke up, the scores of sore throat 6 h after the operation and 24 h after operation were lower than those in the control group, and the difference was statistically significant (P < 0.05). The number of cases of postoperative cerebrospinal fluid leakage and intracranial infection was higher than that of the control group, but there was no statistically significant difference from the control group (P > 0.05). The hospitalization days of the experimental group was lower than that of the control group, and the difference was statistically significant (P < 0.05).

CONCLUSION

Reserving a gastric tube in the endoscopic endonasal resection of pituitary tumors, combined with intraoperative and postoperative gastrointestinal decompression, can effectively reduce the incidence of nausea, reduce the number of vomiting and aspiration in patients, and reduce the complications of sore throat The incidence rate shortened the hospitalization days of the patients.

Keywords: Neuroendoscopy, Endonasal approach, Pituitary tumor, Reserved gastric tube, Nausea, Vomiting, Aspiration, Complications

Core Tip: Pituitary tumors are common primary intracranial tumors in clinical practice, accounting for about 10% of intracranial tumors, second only to neuroepithelial tumors and meningiomas. Neuroendoscopic approach has the advantages of clear operative field, convenient tumor removal, and less damage, and is the development direction of modern neurosurgery. It has been found in clinical practice that some patients with this type of surgery may experience Post-Operative Nausea and Vomiting and other discomforts. The main consideration is that there is a correlation with the endonasal approach surgery. Aiming at the above postoperative problems, this study adopted the intervention method of reserving gastric tube in endoscopic endonasal resection of pituitary tumors to explore the application of reserved gastric tube in patients, and achieved good results.