Department of Surgery, Osaka Red Cross Hospital, 5-30, Fudegasaki, Tennouji-ku, Osaka, 543-8555, Japan.
World J Surg Oncol. 2019 Aug 16;17(1):144. doi: 10.1186/s12957-019-1690-9.
The number of patients who are undergoing laparoscopic gastrectomy for treating gastric cancer is increasing. Although prophylactic drains have been widely employed following the procedure, there are few studies reporting the efficacy of prophylactic drainage. Therefore, this study assessed the efficacy of prophylactic drains following laparoscopic gastrectomy for gastric cancer.
Data of patients who received laparoscopic gastrectomy for treating gastric cancer in our institution between April 2011 and March 2017 were reviewed, and the outcomes of patients with and without a prophylactic drainage were compared. Propensity score matching was used to minimize potential selection bias.
A total of 779 patients who underwent surgery for gastric cancer were reviewed; of these, 628 patients who received elective laparoscopic gastrectomy were included in this study. After propensity score matching, data of 145 pairs of patients were extracted. No significant differences were noted in the incidence of postoperative complications between the drain and no-drain groups (19.3% vs 11.0%, P = 0.071). The days after the surgery until the initiation of soft diet (6.3 ± 7.4 vs 4.9 ± 2.9 days, P = 0.036) and the length of postoperative hospital stay (15.7 ± 12.9 vs 13.0 ± 6.3 days, P = 0.023) were greater in the drain group than those in the no-drain group.
This study suggests that routinely using prophylactic drainage following laparoscopic gastrectomy for treating gastric cancer is not obligatory.
接受腹腔镜胃癌手术的患者数量正在增加。尽管术后广泛使用预防性引流,但很少有研究报告预防性引流的疗效。因此,本研究评估了预防性引流在腹腔镜胃癌手术中的疗效。
回顾了 2011 年 4 月至 2017 年 3 月期间在我院接受腹腔镜胃癌手术的患者数据,并比较了有和无预防性引流患者的结局。采用倾向评分匹配来尽量减少潜在的选择偏倚。
共回顾了 779 例接受胃癌手术的患者;其中,628 例接受择期腹腔镜胃癌手术的患者纳入本研究。经过倾向评分匹配,提取了 145 对患者的数据。引流组和非引流组术后并发症的发生率无显著差异(19.3%比 11.0%,P=0.071)。引流组术后开始软食的天数(6.3±7.4 天比 4.9±2.9 天,P=0.036)和术后住院时间(15.7±12.9 天比 13.0±6.3 天,P=0.023)长于非引流组。
本研究表明,在腹腔镜胃癌手术中常规使用预防性引流并非必需。