Our Summary

This research paper is about the use of prophylactic drains in surgeries for stomach cancer. These drains are often used, but some evidence has suggested they might not be necessary. The researchers wanted to see how these drains affected the outcomes of surgery. They looked at randomized controlled trials (RCTs) and cohort studies from several databases, going from 1990 to 2019.

They looked at different outcomes like leakage at the surgery site, need for reoperation, additional drain procedures, how long the patient stayed in the hospital, complications after surgery, deaths after surgery, readmission rates, and complications related to the drain. They included 3 RCTs (330 patients) and 7 cohort studies (2897 patients). Most of the studies were from Eastern countries.

When they analyzed the RCTs, they found that not using a drain could reduce the number of complications after surgery by half, and slightly reduced the time the patient spent in the hospital. There was only one death after surgery in the group that had a drain. Other outcomes were either not reported or only reported by one RCT.

When they looked at the cohort studies, they didn’t find any significant differences. However, the results suggest that not using a prophylactic drain can reduce complications and the length of hospital stay, without significantly affecting other important surgery outcomes.

FAQs

  1. What was the main focus of the research on prophylactic drains in stomach cancer surgeries?
  2. What were the main outcomes the researchers looked at in the studies?
  3. What were the findings of the research regarding the use of prophylactic drains in stomach cancer surgeries?

Doctor’s Tip

A helpful tip a doctor might tell a patient about gastrectomy is that the use of prophylactic drains during surgery may not always be necessary. Research suggests that not using a drain can reduce complications after surgery and slightly decrease the length of hospital stay. It is important to discuss the potential benefits and risks with your healthcare provider before undergoing gastrectomy surgery.

Suitable For

Patients who are typically recommended gastrectomy include those with early-stage stomach cancer that has not spread to other parts of the body, patients with large or advanced tumors that cannot be removed by other means, patients with certain types of stomach tumors that are not responsive to chemotherapy or radiation therapy, and patients with stomach cancer that has recurred after previous treatment. Additionally, patients who are at high risk for developing stomach cancer, such as those with a family history of the disease or certain genetic factors, may also be recommended for gastrectomy as a preventive measure.

Timeline

Before gastrectomy, a patient typically undergoes several tests and evaluations to determine the best course of treatment. This may include imaging tests, blood tests, and consultations with various medical professionals. Once the decision is made to proceed with gastrectomy, the patient will likely undergo preoperative preparations such as fasting and medication adjustments.

After gastrectomy, the patient will typically spend several days in the hospital recovering from surgery. They will be closely monitored for any signs of complications such as infection or bleeding. The patient will gradually transition from a liquid diet to solid foods, with guidance from a dietitian. They will also receive instructions on how to care for their incision site and manage any pain or discomfort.

In the weeks and months following gastrectomy, the patient will have regular follow-up appointments with their healthcare team to monitor their recovery and adjust their treatment plan as needed. They may also undergo additional treatments such as chemotherapy or radiation therapy, depending on the stage and type of stomach cancer.

Overall, the timeline for a patient before and after gastrectomy involves thorough preoperative evaluations, careful postoperative monitoring and recovery, and ongoing follow-up care to ensure the best possible outcomes.

What to Ask Your Doctor

  1. What are the potential risks and benefits of using a prophylactic drain during gastrectomy surgery?
  2. Are there alternative methods or strategies for preventing complications after surgery that could be considered instead of using a drain?
  3. How common are complications related to drains after gastrectomy surgery, and how are they typically managed?
  4. What criteria are used to determine whether or not a patient will receive a prophylactic drain during gastrectomy surgery?
  5. How does the use of a prophylactic drain during gastrectomy surgery affect the recovery process and overall outcome of the surgery?
  6. Are there any specific factors or characteristics that might make a patient more or less likely to benefit from the use of a prophylactic drain during gastrectomy surgery?
  7. Are there any ongoing research studies or clinical trials investigating the use of prophylactic drains in gastrectomy surgery that I should be aware of?
  8. How will the decision to use or not use a prophylactic drain during gastrectomy surgery be made, and what factors will be taken into consideration?
  9. What follow-up care or monitoring will be needed if a prophylactic drain is used during gastrectomy surgery, and how long will the drain typically remain in place?
  10. Are there any specific questions or concerns I should discuss with my healthcare team before making a decision about the use of a prophylactic drain during gastrectomy surgery?

Reference

Authors: Weindelmayer J, Mengardo V, Veltri A, Torroni L, Zhao E, Verlato G, de Manzoni G. Journal: Eur J Surg Oncol. 2020 Aug;46(8):1396-1403. doi: 10.1016/j.ejso.2020.05.009. Epub 2020 May 15. PMID: 32457016