CHAMGAP
APPROVEDReviewed and approved by the Chamgap Editorial Team (2026-08-14). The draft was written by AI, the existence of all 2 cited sources was verified at the original page, and the verdict passed blind grading and adversarial audit. Methodology v0.7.
Verdict No. 2590 · Search date 2026-08-14 · Methodology v0.7

Routine nasogastric decompression,
does it really help with Prevention of pneumonia and pulmonary complications?

30-Second Summary
D
Evidence Grade D · 30 · Safety warning
Routine nasogastric decompression did not prevent pulmonary complications after hepatectomy and one trial reported more pneumonia
Pneumonia, atelectasis, and severe discomfort were reported with continued tubes. Aspiration, mucosal injury, and malposition risks require a clear indication and clinical monitoring.
What the
research shows
The grade is D with 30 points. In a 200-participant French trial, pneumonia was more frequent with continued nasogastric decompression, 13/100 versus 5/100 after removal at the end of surgery, P=0.047. A 210-participant Japanese trial found pulmonary complications of 18.5% versus 19.5%, P=0.84. F was not assigned because prespecification of pulmonary harm as a primary or safety endpoint and a pooled confidence interval were not confirmed.
What the
ads claim
Draining gastric contents and gas and reducing gastric distension are physical functions. They did not translate into prevention of pneumonia or atelectasis, and one trial observed more pulmonary events.
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Useful facts when choosing a product

  • A nasogastric tube passes through the nose into the stomach to drain contents and gas.
  • Continued groups kept the tube until passage of flatus or stool; controls removed it at the end of surgery.
  • In Pessaux, 21 tube patients reported severe discomfort and 19 required premature removal.
Gap Measurement · Verdict 2590 · D 30
What advertising claims
What independent, higher-quality research supports
△ GAP
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What the research actually shows

Pessaux and colleagues randomized 200 elective hepatectomy patients at one French hospital, 100 per group, to continued decompression until flatus or stool versus removal at surgery end. Ichida and colleagues randomized 210 patients at one Japanese center, 108 continued versus 102 removed, and registered UMIN000003220. Author teams did not overlap, but specific funding could not be verified for both trials, so independent funding replication was not claimed.

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Why this is classified as D (30)

Two trials in the same hepatectomy context did not show pulmonary benefit, but prespecified harm status and pooled precision were not confirmed, so the verdict is D rather than F, with 30 points.

Counterpoint. This applies to routine continuation after uncomplicated elective hepatectomy. Selective reinsertion for vomiting, ileus, or obstruction is a different clinical situation.

Rejudgment record. Cross-check applied — Cross-checked populations, interventions, pulmonary results, overall morbidity, registration, and funding verification limits against both articles and the UMIN record; prespecified harm remained unconfirmed

Scoring profile behind this grade
EndpointHHard endpoint - actual events such as death
ReplicationR1Single confirmatory trial
IndependenceI1Mixed funding sources
Effect sizeE0Null
PrecisionCXNo pooled confidence interval could be confirmed

The scoring table and the verdict agree (D).

Sub-claim grades by effect

This ingredient is marketed for several effects. A single overall grade blends strong and weak claims together, so each effect is graded separately here. The overall grade reflects the strongest disconfirming or core claim.

Effect (sub-claim)GradeBasis
Routine nasogastric decompression prevents pulmonary complications after hepatectomyDTwo trials found no benefit, and one reported more pneumonia.
Continued nasogastric decompression reduces overall complications after hepatectomyDBoth trials were null, 15% versus 19% and 34.3% versus 35.3%.

Cross-check — Codex and Claude

This verdict was drafted by Codex through literature review and source-existence checks, cross-checked through blind grading and adversarial audit, and settled by reapplying the methodology boundary rules. Cases with split grades were resolved through rejudgment.
03

Evidence Table

StudyDesignSampleFundingEndpointResultWeight
Study 1Single-center French randomized trial100PubMed indexed non-US government research support, but the specific institution was not verifiedPostoperative morbidity including pneumonia and atelectasisPneumonia 13/100 versus 5/100, P=0.047; atelectasis 81/100 versus 67/100, P=0.043; overall surgical complications 15% versus 19%, P=0.451First direct trial with a harm signal
Study 2Single-center Japanese registered randomized trial102Specific funding statement not verifiedOverall morbidity, pulmonary complications, vomiting, oral intake, and length of stayPulmonary complications 18.5% versus 19.5%, P=0.84; overall morbidity 34.3% versus 35.3%, P=0.99Second null trial in the same indication, with funding and prespecification limitations
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Receipt — 2 References

All 2 cited sources were verified for existence at the original page (as of 2026-08-14).

Pessaux P, Regimbeau JM, Dondéro F, Plasse M, Mantz J, Belghiti J. Randomized clinical trial evaluating the need for routine nasogastric decompression after elective hepatic resection. Br J Surg. 2007;94(3):297-303. PMID: 17315273. DOI: 10.1002/bjs.5728.
checked
Ichida H, Imamura H, Yoshimoto J, Sugo H, Ishizaki Y, Kawasaki S. Randomized Controlled Trial for Evaluation of the Routine Use of Nasogastric Tube Decompression After Elective Liver Surgery. J Gastrointest Surg. 2016;20(7):1324-1330. PMID: 27197829. DOI: 10.1007/s11605-016-3116-0. UMIN000003220.
checked
Draft and rewrite: Codex (AI) · Verification: Codex blind grading and adversarial audit · Final adjudication: Claude
Reviewed and approved: Chamgap Editorial Team · Approval date: 2026-08-14 · Corrections: none

Cite this verdict

Routine nasogastric decompression x pulmonary complications after hepatectomy Evidence Grade D card
[Chamgap] Routine nasogastric decompression x pulmonary complications after hepatectomy — Evidence Grade D·30. 2 cited sources checked. Source: https://chamgap.com/en/verdicts/gut/routine-nasogastric-decompression-hepatectomy-pulmonary-complications/ · CC BY 4.0

CC BY 4.0 — free to use with attribution; do not distort grades, numbers, or verdict meaning.

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What this document does and does not do

Chamgap is an information source. It reports what research has and has not confirmed; it does not tell readers what to take or buy. That decision belongs to readers and, when needed, medical or legal professionals. This verdict reflects literature available up to the search date and may change as new research appears. Nothing here is medical advice.