胃癌根治切除术预防性放置腹腔引流管随机对照研究

Prospective randomized study of abdominal drains in gastric cancer surgery

目的探讨胃癌根治切除手术时是否需要预防性放置腹腔引流管。方法将2005年7月至2006年6月南京军区南京总医院胃癌手术病人随机分为两组,无腹腔引流组(51例)不放置腹腔引流管,腹腔引流组(49例)常规放置腹腔引流管。两组病人均采用胃癌D2式切除术,使用相同的围手术期处理方法。观察两组术后并发症发生率及术后恢复情况。结果无腹腔引流组与腹腔引流组相比,术后通气时间、恢复进食时间及术后住院时间差异均无统计学意义。两组术后均无死亡病例,术后并发症发生率差异无统计学意义。结论择期胃癌根治切除术中不常规预防性地放置腹腔引流管是安全有效的。

Objective The aim of this study was to compare the safety and effectiveness of routine drainage and no - drainage regimes after selective gastric cancer surgery. Methods All patients received selective D2 gastric cancer resection, and were randomized divided into two groups： group Ⅰ （no-drains, P = 51 ） , group Ⅱ （with drains, n = 49 ）. The incidence of anastomotic leak and complications specific to the drain as well as other complications were compared in 2 groups. Results The mean length of postoperative stay was （9. 6 ± 2.4 ） d in group I and （ 10. 4 ± 2. 4） d in groupⅡ （ P 〉 0. 05 ）, and postoperative days for oral intake were （ 5. 1 ± 1.6） d in group I and （5.6 ± 2. 3 ） d in group H （ P 〉 0. 05 ）. No significant difference was noted in the incidence of postoperative complication between the no - drain group and the drain group （9.8% vs 12. 2%, P 〉0. 05）. Conclusion Routine abdominal drainage after gastric cancer surgery to prevent anastomotic and other complications is unnecessary.