Prophylactic Abdominal Drainage After Gastrectomy: An Updated Meta-Analysis

Abstract

Abstract Introduction: At present, there is no convincing evidence-based medical basis for the placement of prophylactic drain after gastrectomy.This meta-analysis aimed to analyze the incidence of complications and the recovery of gastrointestinal function after gastrectomy in the drain group and the no-drain group. Methods: Data were retrieved from electronic databases PubMed, EMBASE, Medline, Cochrane Library, CNKI, Wanfang and VIP databases up to December 2022, including the outcomes of individual treatment after gastrectomy. Complication related index:Incidence of Postoperative Complications, Anastomotic leak，Intra-abdominal bleeding, Wound Infection, Hospital mortality, Pulmonary infection, Intra-abdominal abscess, Abdominal infection, Readmission, Reoperation, Drain related complications etc. Recovery of gastrointestinal function related index: Passage of flatus, Initiation of soft diet, Hospital stay after surgery. The Jadad score and Newcastle-Ottawa scale were used to assess the quality of the included studies. Results: After screening, 20 literatures were finally included, including 4984 patients. Meta-analysis results showed that the passage of flatus（WMD=0.32, 95%CI=0.07~0.58, P=0.01）and initiation of soft diet（WMD=0.45, 95%CI=0.20~0.71, P=0.0005）in the no-drain group were better than those in the drain group. The drain group was not superior to the no-drain group in hospital stay after surgery, postoperative complications, wound infection, pulmonary infection, anastomotic leakage, intra-abdominal abscess, intra-abdominal bleeding, intra-abdominal infection, mortality, reoperation, readmission, and drainage-related complications. Conclusions: Prophylactic placement of the peritoneal drainage tube did not reduce the incidence of early complications but delayed recovery of gastrointestinal function. Abdominal drainage is not required after radical gastrectomy, but is recommended for high-risk patients with anastomotic fistula and intraperitoneal bleeding.