World Journal of Laparoscopic Surgery

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VOLUME 17 , ISSUE 3 ( September-December, 2024 ) > List of Articles

RESEARCH ARTICLE

Drain vs No Drain after Performing Totally Laparoscopic Gastrectomy in Gastric Cancer Surgery

Abd-Elfattah Kalmoush, Loay M Gertallah, Amr T Elhawary, Shady E Shaker, Mohamed Elbaz, Amany M Abdallah, Mahmod Ghoname, Mahmoud Sherbiny, Ahmed L Sharaf, Ola A Harb, Asmaa H Mohamed, Alaa A Haggag, Mahmoud Abdelaziz

Keywords : Gastric cancer, Laparoscopic gastrectomy, Prophylactic drain

Citation Information : Kalmoush A, Gertallah LM, Elhawary AT, Shaker SE, Elbaz M, Abdallah AM, Ghoname M, Sherbiny M, Sharaf AL, Harb OA, Mohamed AH, Haggag AA, Abdelaziz M. Drain vs No Drain after Performing Totally Laparoscopic Gastrectomy in Gastric Cancer Surgery. World J Lap Surg 2024; 17 (3):146-148.

DOI: 10.5005/jp-journals-10033-1625

License: CC BY-NC 4.0

Published Online: 16-08-2024

Copyright Statement:  Copyright © 2024; The Author(s).


Abstract

Background: Routine performance of a prophylactic postoperative drainage after abdominal surgeries was done to prevent and manage postoperative intra-abdominal complications. Sure evidence to avoid routine performance of prophylactic drainage after surgery in gastric cancer (GC) patients and its role in reducing postoperative morbidity was not reached yet. Aim: The aim of the present study was to compare between patients who underwent prophylactic drainage and patients who did not undergo prophylactic drainage following total laparoscopic gastrectomy in patients diagnosed with distal GC. Patients and methods: We included 150 patients who underwent totally laparoscopic distal gastrectomy for surgical management of histopathologically confirmed GCs. We divided patients into two groups, the first group included 100 patients and underwent totally laparoscopic gastrectomy with prophylactic drainage, and the other group included 50 patients underwent totally laparoscopic gastrectomy without performing drainage. We compare between both included groups regarding short-term and long-term outcomes. Results: Operative times in the group of patients who have drain group were longer than that in those with no drain. We showed that in the group of patients with drain, the number of days from time of surgery to time of soft diet initiation and time to first flatus was more than that in the no drain group. Conclusion: Avoiding prophylactic drain insertion in some patients after performing totally laparoscopic gastrectomy for management of gastric cancer could be feasible. It increases patients comfort without increasing the risk of postoperative complications.


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  1. Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2021;71(3):209–249. DOI: 10.3322/caac.21660.
  2. Pang HY, Zhao LY, Wang H, et al. Impact of type of postoperative complications on long-term survival of gastric cancer patients: Results from a high-volume institution in China. Front Oncol 2021;11:587309. DOI: 10.3389/fonc.2021.587309.
  3. Mengardo V, Weindelmayer J, Veltri A, et al. Current practice on the use of prophylactic drain after gastrectomy in Italy: The abdominal drain in gastrectomy (ADiGe) survey. Updates Surg 2022;74: 1839–1849. DOI: 10.1007/s13304-022-01397-0.
  4. He S, Xia J, Zhang W, et al. Prophylactic abdominal drainage for pancreatic surgery. Cochrane Database Syst Rev 2021;12:Cd010583. DOI: 10.1002/14651858.CD010583.pub5.
  5. Dezfouli SA, Ünal UK, Ghamarnejad O, et al. Systematic review and meta-analysis of the efficacy of prophylactic abdominal drainage in major liver resections. Sci Rep 2021;11:3095. DOI: 10.1038/s41598-021-82333-x.
  6. Pang HY, Chen LH, Chen XF, et al. Prophylactic drainage versus non-drainage following gastric cancer surgery: A meta-analysis of randomized controlled trials and observational studies. World J Surg Oncol 2023;21:166. DOI: 10.1186/s12957-023-03054-1.
  7. Weindelmayer J, Mengardo V, Veltri A, et al. Should we still use prophylactic drain in gastrectomy for cancer? A systematic review and meta-analysis. Eur J Surg Oncol 2020;46:1396–1403. DOI: 10.1016/j.ejso.2020.05.009.
  8. Japanese Gastric Cancer Association. Japanese gastric cancer treatment guidelines 2014 (ver. 4). Gastric Cancer 2017;20:1–19. DOI: 10.1007/s10120-016-0622-4.
  9. Shimoike N, Akagawa S, Yagi D, et al. Laparoscopic gastrectomy with and without prophylactic drains in gastric cancer: A propensity score-matched analysis. World J Surg Oncol 2019;17:144. DOI: 10.1186/s12957-019-1690-9.
  10. Miura S, Kanaya S, Hosogi H, et al. Esophagojejunostomy with linear staplers in laparoscopic total gastrectomy: Experience with 168 cases in 5 consecutive years. Surg Laparosc Endosc Percutan Tech 2017;27:e101–e107. DOI: 10.1186/s12957-019-1690-9.
  11. Hirahara N, Matsubara T, Hayashi H, et al. Significance of prophylactic intraabdominal drain placement after laparoscopic distal gastrectomy for gastric cancer. World J Surg Oncol 2015;13: 181. DOI: 10.1186/s12957-015-0591-9.
  12. Alvarez Uslar R, Molina H, Torres O, et al. Total gastrectomy with or without abdominal drains. A prospective randomized trial. Rev Esp Enferm Dig 2005;97:562–569. DOI: 10.4321/s1130-01082005000800004.
  13. Kumar M, Yang SB, Jaiswal VK, et al. Is prophylactic placement of drains necessary after subtotal gastrectomy? World J Gastroenterol 2007;13:3738–3741. DOI: 10.3748/wjg.v13.i27.3738.
  14. Liu H, Jin P, Quan X, et al. Feasibility of totally laparoscopic gastrectomy without prophylactic drains in gastric cancer patients. World J Gastroenterol 2021;27(26):4236–4245. DOI: 10.3748/wjg.v27.i26.4236.
  15. Messager M, Sabbagh C, Denost Q, et al. Is there still a need for prophylactic intra-abdominal drainage in elective major gastro-intestinal surgery? J Visc Surg 2015;152:305–313. DOI: 10.1016/j.jviscsurg.2015.09.008.
  16. Lee J, Choi YY, An JY, et al. Do all patients require prophylactic drainage after gastrectomy for gastric cancer? Ann Surg Oncol 2015;22:3929–3937. DOI: 10.1245/s10434-015-4521-4.
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