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
ARTICLE HIGHLIGHTS
Research 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 (PONV) and other discomforts.

Research motivation

At present, it has been found that some patients after endonasal endosphenoidal neuroendoscopy surgery may experience PONV and other discomforts. Whether there can be corresponding methods to avoid the occurrence of similar events is our research motivation.

Research objectives

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

Research methods

Patients who underwent pituitary adenoma resection via the endoscopic endonasal approach were selected and randomly divided into the experimental and control groups. 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.

Research results

The times of postoperative nausea and vomiting in the experimental group were lower than that in the control group. The number of cases of postoperative cerebrospinal fluid leakage and intracranial infection was higher than that of the control group. The hospitalization days of the experimental group was lower than that of the control group.

Research conclusions

Reserved gastric tube application in the resection of pituitary tumors through the endoscopic approach through the nose can predictably improve patients’ postoperative pharyngeal discomfort and improve the symptoms of postoperative vomiting and aspiration.

Research perspectives

In the next step, we can further study the pressure attracted by the negative pressure of the reserved gastric tube and the use time of the reserved gastric tube, so as to better propose the scheme of the reserved gastric tube.