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胃大部切除术后预防性放置引流管有必要吗?

Is prophylactic placement of drains necessary after subtotal gastrectomy?

作者信息

Kumar Manoj, Yang Seung Bong, Jaiswal Vijay Kumar, Shah Jay N, Shreshtha Manish, Gongal Rajesh

机构信息

Department of Surgery, Patan Hospital, Kathmandu, Nepal.

出版信息

World J Gastroenterol. 2007 Jul 21;13(27):3738-41. doi: 10.3748/wjg.v13.i27.3738.

Abstract

AIM

To determine the evidence-based values of prophylactic drainage in gastric cancer surgery.

METHODS

One hundred and eight patients, who underwent subtotal gastrectomy with D1 or D2 lymph node dissection for gastric cancer between January 2001 and December 2005, were divided into drain group or no-drain group. Surgical outcome and post-operative complications within four weeks were compared between the two groups.

RESULTS

No significant differences were observed between the drain group and no-drain group in terms of operating time (171 +/- 42 min vs 156 +/- 39 min), number of post-operative days until passage of flatus (3.7 +/- 0.5 d vs 3.5 +/- 1.0 d), number of post-operative days until initiation of soft diet (4.9 +/- 0.7 d vs 4.8 +/- 0.8 d), length of post-operative hospital stay (9.3 +/- 2.2 d vs 8.4 +/- 2.4 d), mortality rate (5.4% vs 3.8%), and overall post-operative complication rate (21.4% vs 19.2%).

CONCLUSION

Prophylactic drainage placement is not necessary after subtotal gastrectomy for gastric cancer since it does not offer additional benefits for the patients.

摘要

目的

确定胃癌手术中预防性引流的循证价值。

方法

将2001年1月至2005年12月期间接受D1或D2淋巴结清扫的胃癌胃大部切除术的108例患者分为引流组和非引流组。比较两组的手术结果和四周内的术后并发症。

结果

引流组和非引流组在手术时间(171±42分钟对156±39分钟)、术后直至排气的天数(3.7±0.5天对3.5±1.0天)、术后直至开始软食的天数(4.9±0.7天对4.8±0.8天)、术后住院时间(9.3±2.2天对8.4±2.4天)、死亡率(5.4%对3.8%)和总体术后并发症发生率(21.4%对19.2%)方面均未观察到显著差异。

结论

胃癌胃大部切除术后无需放置预防性引流,因为它对患者没有额外益处。

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