Skip to main content
Top
Published in: World Journal of Surgical Oncology 1/2019

Open Access 01-12-2019 | Gastrectomy | Research

Laparoscopic gastrectomy with and without prophylactic drains in gastric cancer: a propensity score-matched analysis

Authors: Norihiro Shimoike, Shin Akagawa, Daisuke Yagi, Masazumi Sakaguchi, Yukinari Tokoro, Eiichiro Nakao, Takuya Tamura, Yusuke Fujii, Yuki Mochida, Yoshihisa Umemoto, Hidero Yoshimoto, Seiichiro Kanaya

Published in: World Journal of Surgical Oncology | Issue 1/2019

Login to get access

Abstract

Background

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.

Methods

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.

Results

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.

Conclusions

This study suggests that routinely using prophylactic drainage following laparoscopic gastrectomy for treating gastric cancer is not obligatory.
Literature
1.
go back to reference Hirahara N, Matsubara T, Hayashi H, Takai K, Fujii Y, Tajima Y. Significance of prophylactic intra-abdominal drain placement after laparoscopic distal gastrectomy for gastric cancer. World J Surg Oncol. 2015;13:181.CrossRef Hirahara N, Matsubara T, Hayashi H, Takai K, Fujii Y, Tajima Y. Significance of prophylactic intra-abdominal drain placement after laparoscopic distal gastrectomy for gastric cancer. World J Surg Oncol. 2015;13:181.CrossRef
2.
go back to reference Lee J, Choi YY, An JY, Seo SH, Kim DW, Seo YB, Nakagawa M, Li S, Cheong JH, Hyung WJ, Noh SH. Do all patients require prophylactic drainage after gastrectomy for gastric cancer? The experience of a high-volume center. Ann Surg Oncol. 2015;22:3929–37.CrossRef Lee J, Choi YY, An JY, Seo SH, Kim DW, Seo YB, Nakagawa M, Li S, Cheong JH, Hyung WJ, Noh SH. Do all patients require prophylactic drainage after gastrectomy for gastric cancer? The experience of a high-volume center. Ann Surg Oncol. 2015;22:3929–37.CrossRef
3.
go back to reference Shi Y, Xu X, Zhao Y, Qian F, Tang B, Hao Y, Luo H, Chen J, Yu P. Short-term surgical outcomes of a randomized controlled trial comparing laparoscopic versus open gastrectomy with D2 lymph node dissection for advanced gastric cancer. Surg Endosc. 2018;32:2427–33.CrossRef Shi Y, Xu X, Zhao Y, Qian F, Tang B, Hao Y, Luo H, Chen J, Yu P. Short-term surgical outcomes of a randomized controlled trial comparing laparoscopic versus open gastrectomy with D2 lymph node dissection for advanced gastric cancer. Surg Endosc. 2018;32:2427–33.CrossRef
4.
go back to reference Petrowsky H, Demartines N, Rousson V, Clavien PA. Evidence-based value of prophylactic drainage in gastrointestinal surgery: a systematic review and meta-analyses. Ann Surg. 2004;240:1074–85.CrossRef Petrowsky H, Demartines N, Rousson V, Clavien PA. Evidence-based value of prophylactic drainage in gastrointestinal surgery: a systematic review and meta-analyses. Ann Surg. 2004;240:1074–85.CrossRef
5.
go back to reference Kim J, Lee J, Hyung WJ, Cheong JH, Chen J, Choi SH, Noh SH. Gastric cancer surgery without drains: a prospective randomized trial. J Gastrointest Surg. 2004;8:727–32.CrossRef Kim J, Lee J, Hyung WJ, Cheong JH, Chen J, Choi SH, Noh SH. Gastric cancer surgery without drains: a prospective randomized trial. J Gastrointest Surg. 2004;8:727–32.CrossRef
6.
go back to reference Kumar M, Yang SB, Jaiswal VK, Shah JN, Shreshtha M, Gongal R. Is prophylactic placement of drains necessary after subtotal gastrectomy? World J Gastroenterol. 2007;13:3738–41.CrossRef Kumar M, Yang SB, Jaiswal VK, Shah JN, Shreshtha M, Gongal R. Is prophylactic placement of drains necessary after subtotal gastrectomy? World J Gastroenterol. 2007;13:3738–41.CrossRef
7.
go back to reference Alvarez UR, Molina H, Torres O, Cancino A. Total gastrecyomy with or without abdominal drains: a prospective randomized trial. Rev Esp Enferm Dig. 2005;97:562–9. Alvarez UR, Molina H, Torres O, Cancino A. Total gastrecyomy with or without abdominal drains: a prospective randomized trial. Rev Esp Enferm Dig. 2005;97:562–9.
8.
go back to reference Ishikawa K, Matsumata T, Kishihara F, Fukayama Y, Masuda H. Laparoscopy-assisted distal gastrectomy for early gastric cancer with versus without prophylactic drainage. Surg Today. 2011;41:1049–53.CrossRef Ishikawa K, Matsumata T, Kishihara F, Fukayama Y, Masuda H. Laparoscopy-assisted distal gastrectomy for early gastric cancer with versus without prophylactic drainage. Surg Today. 2011;41:1049–53.CrossRef
9.
go back to reference Japanese Gastric Cancer Association. Japanese gastric cancer treatment guidelines 2010 (ver.3). Gastric Cancer. 2011;14:238–44. Japanese Gastric Cancer Association. Japanese gastric cancer treatment guidelines 2010 (ver.3). Gastric Cancer. 2011;14:238–44.
10.
go back to reference Japanese Gastric Cancer Association. Japanese gastric cancer treatment guidelines 2014 (ver.4). Gastric Cancer. 2016;20:1–19.CrossRef Japanese Gastric Cancer Association. Japanese gastric cancer treatment guidelines 2014 (ver.4). Gastric Cancer. 2016;20:1–19.CrossRef
11.
go back to reference Kanaya S, Gomi T, Momoi H, Tamaki N, Isobe H, Katayama T, Wada Y, Ohtoshi M. Delta-shaped anastomosis in totally laparoscopic Billroth I gastrectomy: new technique of intraabdominal gastroduodenostomy. J Am Coll Surg. 2002;195(2):284–7.CrossRef Kanaya S, Gomi T, Momoi H, Tamaki N, Isobe H, Katayama T, Wada Y, Ohtoshi M. Delta-shaped anastomosis in totally laparoscopic Billroth I gastrectomy: new technique of intraabdominal gastroduodenostomy. J Am Coll Surg. 2002;195(2):284–7.CrossRef
12.
go back to reference Okabe H, Obama K, Tanaka E, Nomura A, Kawamura J, Nagayama S, Itami A, Watanabe G, Kanaya S, Sakai Y. Intracorporeal esophago-jejunal anastomosis after laparoscopic total gastrectomy for patients with gastric cancer. Surg Endosc. 2009;23(9):2167–71.CrossRef Okabe H, Obama K, Tanaka E, Nomura A, Kawamura J, Nagayama S, Itami A, Watanabe G, Kanaya S, Sakai Y. Intracorporeal esophago-jejunal anastomosis after laparoscopic total gastrectomy for patients with gastric cancer. Surg Endosc. 2009;23(9):2167–71.CrossRef
13.
go back to reference Miura S, Kanaya S, Hosogi H, Kawada H, Akagawa S, Shimoike N, Okumura S, Okada T, Ito T, Arimoto A. Esophagojejunostomy with linear staplers in laparoscopic total gastrectomy: experience with 168 cases in 5 consecutive years. Surg Laparosc Endosc Percutan Tech. 2017;27:e101–7.CrossRef Miura S, Kanaya S, Hosogi H, Kawada H, Akagawa S, Shimoike N, Okumura S, Okada T, Ito T, Arimoto A. Esophagojejunostomy with linear staplers in laparoscopic total gastrectomy: experience with 168 cases in 5 consecutive years. Surg Laparosc Endosc Percutan Tech. 2017;27:e101–7.CrossRef
14.
go back to reference Tanigawa N, Lee SW, Kimura T, Mori T, Uyama I, Nomura E, Okuda J, Konishi F. The endoscopic surgical skill qualification system for gastric surgery in Japan. Asian J Endosc Surg. 2011;4:112–5.CrossRef Tanigawa N, Lee SW, Kimura T, Mori T, Uyama I, Nomura E, Okuda J, Konishi F. The endoscopic surgical skill qualification system for gastric surgery in Japan. Asian J Endosc Surg. 2011;4:112–5.CrossRef
15.
go back to reference Kitano S, Iso Y, Moriyama M, Sugimachi K. Laparoscopy-assisted Billoth I gastrectomy. Surg Laparosc Endosc. 1994;4(2):146–8.PubMed Kitano S, Iso Y, Moriyama M, Sugimachi K. Laparoscopy-assisted Billoth I gastrectomy. Surg Laparosc Endosc. 1994;4(2):146–8.PubMed
16.
go back to reference Etoh T, Shiraishi N, Kitano S. Current trends of laparoscopic gastrectomy for gastric cancer in Japan. Asian J Endosc Surg. 2009;2:18–23.CrossRef Etoh T, Shiraishi N, Kitano S. Current trends of laparoscopic gastrectomy for gastric cancer in Japan. Asian J Endosc Surg. 2009;2:18–23.CrossRef
17.
go back to reference Katai H, Sasako M, Fukuda H, Nakamura K, Hiki N, Saka M, Yamaue H, Yoshikawa T, Kojima K, the JCOG Gastric Cancer Surgical Study Group. Safety and feasibility of laparoscopy-assisted distal gastrectomy with suprapancreatic nodal dissection for clinical stage I gastric cancer: a multicenter phase II trial (JCOG 0703). Gastric Cancer. 2010;13:238–44.CrossRef Katai H, Sasako M, Fukuda H, Nakamura K, Hiki N, Saka M, Yamaue H, Yoshikawa T, Kojima K, the JCOG Gastric Cancer Surgical Study Group. Safety and feasibility of laparoscopy-assisted distal gastrectomy with suprapancreatic nodal dissection for clinical stage I gastric cancer: a multicenter phase II trial (JCOG 0703). Gastric Cancer. 2010;13:238–44.CrossRef
18.
go back to reference Kim HH, Hyung WJ, Cho GS, Kim MC, Han SU, Kim W, Ryu SW, Lee HJ, Song KY. Morbidity and mortality of laparoscopic gastrectomy versus open gastrectomy for gastric cancer: an interim report – a phase III multicenter, prospective, randomized trial (KLASS Trial). Ann Surg. 2010;251:417–20.CrossRef Kim HH, Hyung WJ, Cho GS, Kim MC, Han SU, Kim W, Ryu SW, Lee HJ, Song KY. Morbidity and mortality of laparoscopic gastrectomy versus open gastrectomy for gastric cancer: an interim report – a phase III multicenter, prospective, randomized trial (KLASS Trial). Ann Surg. 2010;251:417–20.CrossRef
19.
go back to reference Inaki N, Etoh T, Ohyama T, Uchiyama K, Katada N, Koeda K, Yoshida K, Takagane A, Kojima K, Sakuramoto S, Shiraishi N, Kitano S. A multi-institutional, prospective, phase II feasibility study of laparoscopy-assisted distal gastrectomy with D2 lymph node dissection for locally advanced gastric cancer (JLSSG0901). World J Surg. 2015;39(11):2734–41.CrossRef Inaki N, Etoh T, Ohyama T, Uchiyama K, Katada N, Koeda K, Yoshida K, Takagane A, Kojima K, Sakuramoto S, Shiraishi N, Kitano S. A multi-institutional, prospective, phase II feasibility study of laparoscopy-assisted distal gastrectomy with D2 lymph node dissection for locally advanced gastric cancer (JLSSG0901). World J Surg. 2015;39(11):2734–41.CrossRef
20.
go back to reference Demange MK, Fregni F. Limits to clinical trials in surgical areas. Clinics (Sao Paulo). 2011;66(1):159–61.CrossRef Demange MK, Fregni F. Limits to clinical trials in surgical areas. Clinics (Sao Paulo). 2011;66(1):159–61.CrossRef
21.
go back to reference Lonjon G, Boutron I, Trinquart L, Ahmad N, Aim F, Nizard R, Ravaud P. Comarison of treatment effect estimates from prospective nonrandomized studies with propensity score analysis and randomized controlled trials of surgical procedures. Ann Surg. 2014;259(1):18–25.CrossRef Lonjon G, Boutron I, Trinquart L, Ahmad N, Aim F, Nizard R, Ravaud P. Comarison of treatment effect estimates from prospective nonrandomized studies with propensity score analysis and randomized controlled trials of surgical procedures. Ann Surg. 2014;259(1):18–25.CrossRef
Metadata
Title
Laparoscopic gastrectomy with and without prophylactic drains in gastric cancer: a propensity score-matched analysis
Authors
Norihiro Shimoike
Shin Akagawa
Daisuke Yagi
Masazumi Sakaguchi
Yukinari Tokoro
Eiichiro Nakao
Takuya Tamura
Yusuke Fujii
Yuki Mochida
Yoshihisa Umemoto
Hidero Yoshimoto
Seiichiro Kanaya
Publication date
01-12-2019
Publisher
BioMed Central
Published in
World Journal of Surgical Oncology / Issue 1/2019
Electronic ISSN: 1477-7819
DOI
https://doi.org/10.1186/s12957-019-1690-9

Other articles of this Issue 1/2019

World Journal of Surgical Oncology 1/2019 Go to the issue