A Cochrane review included 37 studies with a total of 5 711 subjects. Patients not having routine tube use had an earlier return of bowel function (p<0.00001), a decrease in pulmonary complications (p=0.09) and an insignificant trend toward increase in risk of wound infection (p=0.39) and ventral hernia (p=0.09). Anastomotic leak was no different between groups (p=0.70). Vomiting seemed to favour routine tube use, but with increased patient discomfort. Length of stay was shorter when no tube was used but there was statistical heterogeneity in this analysis. No adverse events specifically related to tube insertion (direct tube trauma) were reported.