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腹腔镜辅助远端胃切除术治疗早期胃癌伴或不伴预防性引流。

Laparoscopy-assisted distal gastrectomy for early gastric cancer with versus without prophylactic drainage.

机构信息

Department of Surgery, Nakatsu Municipal Hospital, 173 Shimoikenaga, Nakatsu, Oita, 871-8511, Japan.

出版信息

Surg Today. 2011 Aug;41(8):1049-53. doi: 10.1007/s00595-010-4448-0. Epub 2011 Jul 20.

Abstract

PURPOSE

Little has been reported on routine prophylactic abdominal drainage after gastrectomy, especially after laparoscopy-assisted distal gastrectomy (LADG). We conducted this retrospective study on patients undergoing LADG to evaluate the benefit of routine drainage in LADG procedures.

METHODS

The subjects were 21 patients who underwent surgery for early gastric cancer (EGC) between January 2004 and March 2008. They comprised 10 who underwent LADG with drainage before January 2006 and 11 who underwent LADG without drainage after February 2006. We compared patient and tumor characteristics, operative results, and postoperative outcomes between the groups.

RESULTS

The no-drain group of patients were able to eat their first meal significantly sooner than the drain group patients (P < 0.01); however, the time to start ambulating, passing flatus, and drinking was similar in the two groups. There were no significant differences between the groups in the postoperative complication rate or the postoperative hospital stay. The drain did not seem to add benefit, and no complications due to the lack of drain placement were noted in the no-drain group.

CONCLUSION

Routine prophylactic abdominal drainage after LADG for EGC may not be necessary.

摘要

目的

关于胃切除术后常规预防性腹部引流,特别是腹腔镜辅助远端胃切除术(LADG)后常规预防性腹部引流的报道较少。我们对接受 LADG 的患者进行了这项回顾性研究,以评估 LADG 术中常规引流的益处。

方法

本研究的对象为 2004 年 1 月至 2008 年 3 月期间接受手术治疗的早期胃癌(EGC)患者 21 例。其中 10 例患者于 2006 年 1 月前接受 LADG 加引流,11 例患者于 2006 年 2 月后接受 LADG 无引流。我们比较了两组患者的一般情况、手术结果和术后结果。

结果

无引流组患者首次进食的时间明显早于引流组患者(P < 0.01);然而,两组患者开始活动、放屁和饮水的时间相似。两组患者的术后并发症发生率和术后住院时间无显著差异。引流似乎没有带来额外的益处,而且在无引流组中也没有因未放置引流管而出现并发症。

结论

LADG 治疗 EGC 后常规预防性腹部引流可能没有必要。

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