Purpose The role of prophylactic abdominal drainage in total gastrectomy is not well-established. This study aimed to evaluate the efficacy of abdominal drainage in the prevention and management of major intra-abdominal complications after total gastrectomy for gastric carcinoma. Materials and Methods We retrospectively reviewed the data of 499 patients who underwent total gastrectomy for gastric carcinoma in a high-volume institution. The patients were divided into drainage and non-drainage groups and compared for the development and management of major intra-abdominal complications, including anastomotic leak, abdominal bleeding, abdominal infection, and pancreatic fistulas. Results The drainage group included 388 patients and the non-drainage group included 111 patients. The 2 groups showed no significant differences in clinicopathological characteristics or operative procedures, except for more frequent D2 lymphadenectomies in the drainage group. After surgery, the overall morbidity (drainage group vs. non-drainage group: 24.7% vs. 28.8%, P=0.385) and incidence of major intra-abdominal complications (6.4% vs. 6.3%, P=0.959) did not significantly differ between the two groups. The non-drainage group showed no significant increase in the incidence rate of major intra-abdominal complications in the subgroups divided by age, sex, comorbidity, operative approach, body mass index, extent of lymphadenectomy, and pathological stage. Abdominal drainage had no significant impact on early diagnosis, secondary intervention or reoperation, or recovery from major intra-abdominal complications. Conclusions Prophylactic abdominal drainage showed little demonstrable benefit in the prevention and management of major intra-abdominal complications of total gastrectomy for gastric carcinoma.

中文翻译：

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腹腔引流预防和处理胃癌全胃切除术后主要腹腔内并发症

目的 预防性腹腔引流在全胃切除术中的作用尚不明确。本研究旨在评估腹腔引流在预防和管理胃癌全胃切除术后主要腹腔内并发症的疗效。材料与方法 我们回顾性分析了一家大型机构接受全胃切除术的 499 例胃癌患者的资料。将患者分为引流组和非引流组，比较主要腹腔内并发症的发生和处理，包括吻合口漏、腹腔出血、腹部感染和胰瘘。结果引流组388例，非引流组111例。除了引流组更频繁的 D2 淋巴结切除术外，2 组在临床病理特征或手术程序方面没有显着差异。手术后，总体发病率（引流组 vs. 非引流组：24.7% vs. 28.8%，P=0.385）和主要腹内并发症发生率（6.4% vs. 6.3%，P=0.959）没有显着差异两组之间存在差异。按年龄、性别、合并症、手术方式、体重指数、淋巴结切除范围和病理分期划分的亚组中，非引流组主要腹腔内并发症的发生率没有显着增加。腹腔引流对早期诊断、二次干预或再次手术或主要腹腔内并发症的恢复没有显着影响。