胃癌根治术预防性放置腹腔引流管的临床意义探讨

Retrospective analysis of abdominal drains in gastric cancer surgery

目的评价胃癌根治术预防性放置腹腔引流管的临床价值。方法回顾分析行择期胃癌根治手术311例患者临床资料,其中245例放置腹腔引流管,其余66例未放腹腔引流管;比较两组患者一般资料、术后恢复情况、术后换药次数、术后住院日数及并发症发生率;记录引流组置管天数和引流情况。结果两组相比,平均年龄、性别构成、手术方式、术后病理分期等差异均无统计学意义。两组均无吻合口瘘及死亡病例,无引流组术后拨胃管时间要早于引流组,但两组间术后住院日数差异无统计学意义;引流组平均置管时间(8.3±2.2)d,引流管无明显液体引出,或仅有少量渗液。结论胃癌根治术不必常规预防性放置腹腔引流管,应从严掌握预防性放置腹腔引流管的指征,术后应及早拨除。

Objective To aprize the effect of routine abdominal drainage and no-drainage in selective gastric cancer surgery. Methods The clinical data of 311 patients ,245 of which with drains and the others（ 66 ）without, who received gastric cancer surgery were analyzed. The general information and which about recovery after surgery and the incidence of postoperative complications were compared in 2 groups. Results There were no significant difference between 2 groups（ P 〉 0. 05 ） in the general information, surgical complication rate and postoperative hospital days. And there were no anastomotic leak occurred in all patients. On an average, the stomach drainage were removed earlier in no-drainage group than in drainage group（ P ≈0. 013 ） and the abdominal drainage were removed in （ 8.3 ± 2. 2） days after operation and meanwhile, the drainage measures were usually few. Conclusion Routine abdominal drainage after gastric cancer surgery to prevent anastomotic leak and other complications is unnecessary.