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

Janghee Lee, Yoon Young Choi, Ji Yeong An, Sang Hyuk Seo, Dong Wook Kim, Yu Bin Seo, Masatoshi Nakagawa, Shuangxi Li, Jae Ho Cheong, WooJin Hyung, Sung Hoon Noh

Research output: Contribution to journalArticle

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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.

Original languageEnglish
Pages (from-to)3929-3937
Number of pages9
JournalAnnals of Surgical Oncology
Volume22
Issue number12
DOIs
Publication statusPublished - 2015 Nov 1

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Gastrectomy
Stomach Neoplasms
Drainage
Catheters
Odds Ratio
Ascitic Fluid
Abdomen
Minimally Invasive Surgical Procedures
Incidence
Operative Time
Lymph Node Excision
Candida albicans
Statistical Factor Analysis
Randomized Controlled Trials
Escherichia coli

All Science Journal Classification (ASJC) codes

  • Surgery
  • Oncology

Cite this

Lee, Janghee ; Choi, Yoon Young ; An, Ji Yeong ; Seo, Sang Hyuk ; Kim, Dong Wook ; Seo, Yu Bin ; Nakagawa, Masatoshi ; Li, Shuangxi ; Cheong, Jae Ho ; Hyung, WooJin ; Noh, Sung Hoon. / Do All Patients Require Prophylactic Drainage After Gastrectomy for Gastric Cancer? The Experience of a High-Volume Center. In: Annals of Surgical Oncology. 2015 ; Vol. 22, No. 12. pp. 3929-3937.
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title = "Do All Patients Require Prophylactic Drainage After Gastrectomy for Gastric Cancer? The Experience of a High-Volume Center",
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.",
author = "Janghee Lee and Choi, {Yoon Young} and An, {Ji Yeong} and Seo, {Sang Hyuk} and Kim, {Dong Wook} and Seo, {Yu Bin} and Masatoshi Nakagawa and Shuangxi Li and Cheong, {Jae Ho} and WooJin Hyung and Noh, {Sung Hoon}",
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Lee, J, Choi, YY, An, JY, Seo, SH, Kim, DW, Seo, YB, Nakagawa, M, Li, S, Cheong, JH, Hyung, W & Noh, SH 2015, 'Do All Patients Require Prophylactic Drainage After Gastrectomy for Gastric Cancer? The Experience of a High-Volume Center', Annals of Surgical Oncology, vol. 22, no. 12, pp. 3929-3937. https://doi.org/10.1245/s10434-015-4521-4

Do All Patients Require Prophylactic Drainage After Gastrectomy for Gastric Cancer? The Experience of a High-Volume Center. / Lee, Janghee; Choi, Yoon Young; An, Ji Yeong; Seo, Sang Hyuk; Kim, Dong Wook; Seo, Yu Bin; Nakagawa, Masatoshi; Li, Shuangxi; Cheong, Jae Ho; Hyung, WooJin; Noh, Sung Hoon.

In: Annals of Surgical Oncology, Vol. 22, No. 12, 01.11.2015, p. 3929-3937.

Research output: Contribution to journalArticle

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T1 - Do All Patients Require Prophylactic Drainage After Gastrectomy for Gastric Cancer? The Experience of a High-Volume Center

AU - Lee, Janghee

AU - Choi, Yoon Young

AU - An, Ji Yeong

AU - Seo, Sang Hyuk

AU - Kim, Dong Wook

AU - Seo, Yu Bin

AU - Nakagawa, Masatoshi

AU - Li, Shuangxi

AU - Cheong, Jae Ho

AU - Hyung, WooJin

AU - Noh, Sung Hoon

PY - 2015/11/1

Y1 - 2015/11/1

N2 - 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.

AB - 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.

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