Published online Jul 14, 2021. doi: 10.3748/wjg.v27.i26.4236
Peer-review started: November 10, 2020
First decision: November 30, 2020
Revised: December 16, 2020
Accepted: March 29, 2021
Article in press: March 29, 2021
Published online: July 14, 2021
Prophylactic drains have been used to remove intraperitoneal collections and detect complications early in open surgery. In the last decades, minimally invasive gastric cancer surgery has been performed worldwide. However, reports on routine prophylactic abdominal drainage after totally laparoscopic distal gastrectomy are few.
To evaluate the feasibility of performing totally laparoscopic distal gastrectomy without prophylactic drains in selected patients.
To evaluate the feasibility of performing totally laparoscopic distal gastrectomy without prophylactic drains in selected patients.
Data of patients with distal gastric cancer who underwent totally laparoscopic distal gastrectomy with and without prophylactic drainage at China National Cancer Center/Cancer Hospital from February 2018 to August 2019 were reviewed.
After PSM, data of 42 pairs were extracted. The incidence of concurrent illness was higher in the drain group (42.9% vs 31.0%, P = 0.258). The overall postoperative complication rates were 19.5% and 10.6% in the drain (n = 76) and no-drain groups (n = 49), respectively; there were no significant differences between the two groups (P > 0.05). The difference between the two groups based on the need for percutaneous catheter drainage was also not significant (9.8% vs 6.4%, P = 0.700). However, patients with a larger body mass index (≥ 29 kg/m2) were prone to postoperative complications (P = 0.042). In addition, the number of days from surgery until the first flatus (4.33 ± 1.24 d vs 3.57 ± 1.85 d, P = 0.029) was greater in the drain group.
Omitting prophylactic drainage may reduce surgery time and result in faster recovery. Routine prophylactic drains are not necessary in selected patients. A prophylactic drain may be useful in high-risk patients.
Omitting the use of prophylactic drains can significantly improve the postoperative comfort of patients and does not increase the risk of postoperative complications.