Do nasogastric or nasoenteric tubes improve outcomes from adhesional small bowel obstruction: a systematic review and meta-analysis
Bibliographic record
Abstract
OBJECTIVES: To compare outcomes of nasogastric (NGT) or nasoenteric tube decompression against no decompression in the non-operative management of adhesional small bowel obstruction (ASBO) using a systematic review and meta-analysis. METHODS: Database searches up to February 2025 were conducted using Cochrane Library, EMBASE, MEDLINE and SCOPUS. Abstract screening and data extraction were performed by two independent reviewers. Patients aged 18 and above were included. Studies were excluded if they compared NGTs to long tube devices or if the primary aetiology of SBO was not adhesions. Quality appraisal was conducted using the Newcastle Ottawa Scale and meta-analysis was performed using RevMan Web Software. RESULTS: Searches yielded 1442 studies, of which 4 met the inclusion criteria, comprising a total of 1219 patients undergoing non-operative management for ASBO. These were all retrospective cohort studies. Within these studies, a total of 732 patients had a nasogastric or nasoenteric tube inserted for ASBO while 487 patients were managed without one. NGT use had a non-significant trend toward increased operative intervention, with a pooled odds ratio of 2.58 (95% CI: 0.77 to 8.65; p = 0.09, I² = 82%). Three studies compared bowel resection rates; NGT use was not associated with a statistically significant increased risk of bowel resection (OR 2.31; 95% CI: 0.86-6.16; p = 0.10). All studies reported a longer length of hospital stay in the NGT group. CONCLUSIONS: The available evidence is sparse, limited in design and quality, and marked by high heterogeneity, making it insufficient to draw a definitive conclusion regarding the role of NGTs in ASBO. High-quality evidence from a randomised controlled trial is needed to guide future practice. TRIAL REGISTRATION: PROSPERO (CRD: CRD42021256098).
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.012 | 0.034 |
| Meta-epidemiology (narrow) | 0.002 | 0.002 |
| Meta-epidemiology (broad) | 0.022 | 0.039 |
| Bibliometrics | 0.006 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".