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Prophylactic Drain Versus No Drain in Curative Gastric Cancer Surgery—A Randomized Controlled Trial

  • Original Article
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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

The adoption of enhanced recovery after surgery protocols has questioned the placement of prophylactic drain after curative gastrectomy. A 2015 Cochrane meta-analysis did not find convincing evidence of routine drain placement in gastrectomy, but the quality of evidence was questioned. The present study compared short-term outcomes of prophylactic drain placement versus no drain in gastrectomy.

Methodology

The study is a prospective, non-inferiority, and randomized controlled trial. Histologically proven adenocarcinoma of the stomach undergoing curative gastrectomy with D2 lymphadenectomy was included in the study. Randomization was done intra-operatively. The primary outcome was a postoperative hospital stay. Secondary outcomes included the return of bowel function, achieving adequate enteral feeding, re-surgery, morbidity, and mortality.

Results

One hundred fifty-seven patients were registered, of which 108 patients underwent curative surgery, and were randomized to 54 patients in each group. The median age was 55 years (range: 23–78) and 58.5 years (range: 35–80) in the drain and no drain group. No significant difference was noticed in primary or secondary outcomes in both groups.

Conclusion

Avoid placing a prophylactic drain is not inferior to drain placement following gastrectomy with D2 lymphadenectomy for stomach adenocarcinoma. So, routine prophylactic drain placement can be avoided.

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Data Availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Acknowledgements

We acknowledge the contribution of Mr. Tushar Ranjan Pradhan, a software designer, in designing the surgical oncology database, and Ms. Rukchhanda Nayak, and Mr. Prakash Palei for helping in data-keeping and retrieval.

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Authors and Affiliations

  1. Department of Surgical Oncology, All India Institute of Medical Sciences, Sijua, Patrapada, Bhubaneswar, Odisha, 751019, India

    Dillip Kumar Muduly, Mohammed Imaduddin, Mahesh Sultania, Tim Houghton, Pavan Kumar C. G & Madhabananda Kar

  2. Department of Anaesthesiology, All India Institute of Medical Sciences, Sijua, Patrapada, Bhubaneswar, Odisha, 751019, India

    P Bhaskar Rao, Jayanta Kumar Mitra & Bikram Kishore Behera

  3. Department of Radiodiagnosis, All India Institute of Medical Sciences, Sijua, Patrapada, Bhubaneswar, Odisha, 751019, India

    Sudipta Mohakud

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  1. Dillip Kumar Muduly
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Contributions

Dr Dillip K Muduly: conceptualization, methodology, validation, formal analysis, resources, data curation, writing—original draft, writing—review and editing, and supervision.

Dr. Mohammed Imaduddin: conceptualization, methodology, formal analysis, data curation, writing—original draft,and visualization

Dr. Mahesh Sultania: conceptualization, methodology, data curation, and writing—original draft

Dr. Tim Houghton: methodology, data curation, and writing—review and editing

Dr. Pavan Kumar CG: data curation and writing—review and editing

Dr. P Bhaskar Rao: conceptualization, methodology, and writing—review and editing

Dr. Jayanta Kumar Mitra: validation, methodology, and writing—review and editing

Dr. Bikram Behera: methodology and writing—review and editing

Dr. Sudipta Mohakud: methodology and writing—review and editing

Dr. Madhabananda Kar: conceptualization, methodology, validation, formal analysis, resources, data curation, writing—original draft, writing—review and editing, and supervision

Corresponding author

Correspondence to Dillip Kumar Muduly.

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Muduly, D.K., Imaduddin, M., Sultania, M. et al. Prophylactic Drain Versus No Drain in Curative Gastric Cancer Surgery—A Randomized Controlled Trial. J Gastrointest Surg 26, 2470–2476 (2022). https://doi.org/10.1007/s11605-022-05480-0

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