Efficacy of Prophylactic Drain Placement in Laparoscopic Total Gastrectomy: A Retrospective Study

Abstract

The aim of this study was to assess the efficacy of prophylactic drain placement in laparoscopic total gastrectomy (LTG). Ninety-four patients with gastric cancer who underwent LTG between December 2007 and December 2014 were enrolled in this study. A tube drain was placed in 29 patients after considering it necessary by operators, whereas no tube drain was placed in remaining patients. All patients were classified into either the drain or the no-drain group and were investigated for clinical characteristics and surgical outcomes. Overall, complications occurred in 15 patients and were not significantly different between the drain and no-drain groups [5 (17.2%) versus 10 (15.4%) patients]. No significant difference was observed in median duration of postoperative hospital stay between the drain and no-drain groups (12 versus 12 days). There was no significant difference in the duration of hospital stay regardless of the presence of drains in both groups of patients who developed complications (with drain: 27 days versus without drain: 21.5 days) and those who did not develop complications (with drain: 12 days versus without drain: 12 days). In conclusion, on the basis of the results of this study, routine prophylactic drain placement in LTG may not be necessary because it does not offer any additional benefits for patients.

Abdominal Drainage in the Prevention and Management of Major Intra-Abdominal Complications after Total Gastrectomy for Gastric Carcinoma

“…In a multi-institutional analysis by the US Gastric Cancer Collaborative, which included 344 patients who underwent total gastrectomy, no significant difference was found in the incidence rates of any complications or 30-day mortality between the drainage and non-drainage groups [16]. Another small retrospective study that included 44 patients who underwent total gastrectomy showed similar results, demonstrating no significant differences in postoperative complications and length of hospital stay between the drainage and non-drainage groups [17]. Our study reaffirmed this in a large cohort of patients treated in a specialized high-volume institution.…”

Prophylactic drainage versus non-drainage following gastric cancer surgery: a meta-analysis of randomized controlled trials and observational studies

“…Therefore, more well-designed RCTs with large sample sizes are expected to provide more credible evidence on this issue. Second, several included studies [23,25,32] were published over a large time frame, so improvements in gastric surgery and perioperative management during this time could potentially in uence the results. Third, there was considerable heterogeneity between studies, including the type of drain used and the period of drain placement, which could also have an impact on the reliability of our results.…”

“…The search strategy yielded 1886 potential studies. After title, abstract and full text assessment, 7 RCTs [16-22] and 14 observational [23][24][25][26][27][28][29][30][31][32][33][34][35][36] studies were nally included in the present study. The basic features of the 21 studies involved were shown in Table 1.…”