Letter to the Editor
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 21, 2022; 28(3): 399-401
Published online Jan 21, 2022. doi: 10.3748/wjg.v28.i3.399
Prophylactic drains in totally laparoscopic distal gastrectomy: are they always necessary?
Tommaso Maria Manzia, Alessandro Parente, Roberta Angelico
Tommaso Maria Manzia, Roberta Angelico, HPB and Transplant Unit, Department of Surgery Science, University of Rome Tor Vergata, Rome 00133, Italy
Alessandro Parente, Queen Elizabeth Hospital, Liver Unit, University of Birmingham, Birmingham UK; and HPB and Transplant Unit, Department of Surgery Science, University of Rome Tor Vergata, Rome 00133, Italy
Author contributions: Manzia TM and Angelico R designed the research; Parente A wrote the letter; Manzia TM revised the letter; all authors approved the final version of the manuscript.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest to disclose.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Tommaso Maria Manzia, FEBS, MD, PhD, Associate Professor, HPB and Transplant Unit, Department of Surgery Science, University of Rome Tor Vergata, Viale Oxford 81, Rome 00133, Italy. tomanzia@libero.it
Received: July 18, 2021
Peer-review started: July 18, 2021
First decision: October 3, 2021
Revised: October 5, 2021
Accepted: January 11, 2022
Article in press: January 11, 2022
Published online: January 21, 2022

Prophylactic drains have always been a useful tool to detect early complications and prevent postoperative fluid collections, particularly in gastrointestinal surgery. Recently, the utilization of such drains has been debated, due to mounting evidence that they could be harmful rather than beneficial. Based on recent published articles, Liu et al reported that the routine use of prophylactic drains in total laparoscopic distal gastrectomy might not be necessary for all patients. Herein, we express our opinion regarding this interesting publication.

Keywords: Gastric cancer, Prophylactic drainage, Totally laparoscopic gastrectomy, Enhanced recovery after surgery, Minimally invasive surgery, Early gastric cancer

Core Tip: Historically, prophylactic drains have been used to prevent postoperative collections and detect complications. In recent decades, there have been increasing reports that debate their routine usage in gastrointestinal surgery. Liu et al have shown that prophylactic drains can be safely omitted in selected patients undergoing totally laparoscopic distal gastrectomy. In this letter to the editor, we express our opinion regarding these interesting findings.