Drain versus no-drain after gastrectomy for patients with advanced gastric cancer: systematic review and...

A wide range of outcomes are seen in the literature on the use of drains after gastrectomy. However, there is little consensus on whether or not drains are beneficial in patients with gastric cancer. The purpose of this meta-analysis was to evaluate drain versus no-drain after gastrectomy by using evidence from available randomized controlled trials (RCTs).

We searched PubMed, the Cochrane Library, Embase, VIP, and CNKI for the terms 'gastric cancer', 'gastrectomy' and 'drains' used in combination with the medical subject headings. RCTs were considered. Meta-analysis was performed by RevMan 5.0 software.

Four RCTs involving 438 patients were included. There were no differences between the drain and no-drain groups in the incidence of wound infection, postoperative pulmonary infection, intra-abdominal abscess, mortality, number of postoperative days until passing of flatus and initiation of soft diet. Both the incidence of postoperative complications and the length of hospital stay for patients in the no-drain group after gastrectomy were lower than in the drain group (p = 0.03, 95% CI 0.32, 0.95) and (p = 0.009, 95% CI -1.21, -0.18), respectively.

Avoiding the use of abdominal drains may reduce drain-related complications and shorten hospital stay after gastrectomy.