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Do All Patients Require Prophylactic Drainage After Gastrectomy for Gastric Cancer? The Experience of a High-Volume Center

Authors
 Janghee Lee  ;  Yoon Young Choi  ;  Ji Yeong An  ;  Sang Hyuk Seo  ;  Dong Wook Kim  ;  Yu Bin Seo  ;  Masatoshi Nakagawa  ;  Shuangxi Li  ;  Jae-Ho Cheong  ;  Woo Jin Hyung  ;  Sung Hoon Noh 
Citation
 Annals of Surgical Oncology, Vol.22(12) : 3929-3937, 2015 
Journal Title
 Annals of Surgical Oncology 
ISSN
 1068-9265 
Issue Date
2015
MeSH
Adult ; Age Factors ; Aged ; Aged, 80 and over ; Ascitic Fluid/microbiology ; Drainage/statistics & numerical data* ; Female ; Gastrectomy/adverse effects* ; Gastrectomy/methods ; Hospitals, High-Volume ; Humans ; Male ; Middle Aged ; Operative Time ; Postoperative Care/methods* ; Postoperative Complications/prevention & control ; Risk Factors ; Sex Factors ; Stomach Neoplasms/surgery* ; Young Adult
Keywords
Gastric Cancer ; Advanced Gastric Cancer ; Total Gastrectomy ; Receiver Operating Characteristic Curve ; Peritoneal Fluid
Abstract
BACKGROUND: Although our previous randomized controlled trial showed that there was no difference in postoperative complications after gastric cancer surgery between patients with and without a prophylactic drains (PDs), PDs are commonly used by most surgeons and at most institutions. However, these results have not yet been validated elsewhere. The purpose of this study was to analyze the incidence, characteristics, and risk factors for a postoperative percutaneous catheter drainage (PCD) procedure after gastric cancer surgery when PDs were not used. METHODS: We reviewed data from 1989 patients who underwent gastrectomy with lymphadenectomy for gastric cancer with curative intent from January 2012 to December 2013. RESULTS: The incidence of PCD in the abdomen was 1.8 % (22/1249) and 9.1 % (67/740) in patients with and without PD, respectively. In the without-PD group, age [odds ratio (OR) 1.032; p = 0.013], male gender (OR for female 0.38; p = 0.005), open surgery (OR for minimally invasive surgery 0.16; p = 0.013), and longer operative time (OR 1.01; p < 0.001) were independent risk factors for postoperative PCD in the abdomen. In the without-PD group, no microbes were detected in the peritoneal fluid obtained by PCD in 72.1 % (44/61) of patients who underwent PCD, and the most commonly identified organisms were Escherichia coli and Candida albicans. CONCLUSION: Not using a PD increased the risk of PCD postoperatively, but no microbes in peritoneal fluid were detected in the most patients. Selective use of PD in patients during gastric cancer surgery may be possible using our risk factor analysis.
Full Text
https://link.springer.com/article/10.1245/s10434-015-4521-4
DOI
10.1245/s10434-015-4521-4
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Noh, Sung Hoon(노성훈) ORCID logo https://orcid.org/0000-0003-4386-6886
Cheong, Jae Ho(정재호) ORCID logo https://orcid.org/0000-0002-1703-1781
Choi, Yoon Young(최윤영) ORCID logo https://orcid.org/0000-0002-2179-7851
Hyung, Woo Jin(형우진) ORCID logo https://orcid.org/0000-0002-8593-9214
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/157346
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