Copyright
©The Author(s) 2021.
World J Gastroenterol. Jul 14, 2021; 27(26): 4236-4245
Published online Jul 14, 2021. doi: 10.3748/wjg.v27.i26.4236
Published online Jul 14, 2021. doi: 10.3748/wjg.v27.i26.4236
Table 1 Characteristics of patients who underwent totally laparoscopic distal gastrectomy with or without prophylactic drain
ALL patients | Propensity-matched patients | |||||
Characteristic | Drain (n = 76) | No drain (n = 49) | P value | Drain (n = 42) | No drain (n = 42) | P value |
Sex (M/F) | 54/22 | 33/16 | 0.660 | 31/11 | 29/13 | 0.629 |
Age | 57.58 ± 9.90 | 54.14 ± 12.63 | 0.092 | 57.4 ± 9.9 | 58.1 ± 10.8 | 0.739 |
BMI (kg/m2) | 24.71 ± 3.76 | 24.64 ± 3.72 | 0.915 | 24.3 ± 3.5 | 24.4 ± 2.7 | 0.879 |
ASA (1/2/3), n (%) | 0.562 | 0.565 | ||||
1 | 1 (1.3) | 0 (0.0) | 1 (2.4) | 0 (0.0) | ||
2 | 70 (92.1) | 44 (89.8) | 38 (90.5) | 38 (90.5) | ||
3 | 5 (6.6) | 5 (10.2) | 3 (7.1) | 4 (9.5) | ||
pT stage, n (%) | 0.605 | 0.805 | ||||
T1 | 39 (52.0) | 24 (49.0) | 20 (47.6) | 20 (47.6) | ||
T2 | 10 (13.3) | 11 (22.4) | 6 (14.3) | 10 (23.8) | ||
T3 | 9 (12) | 5 (10.2) | 6 (14.3) | 4 (9.5) | ||
T4a | 17 (22.7) | 9 (18.4) | 10 (23.8) | 8 (19) | ||
pN stage, n (%) | 0.888 | 0.760 | ||||
N0 | 34 (44.7) | 20 (40.8) | 16 (38.1) | 18 (42.9) | ||
N1 | 16 (21.1) | 12 (24.5) | 9 (21.4) | 11 (26.2) | ||
N2 | 14 (18.4) | 7 (14.3) | 9 (21.4) | 5 (11.9) | ||
N3 | 12 (15.8) | 10 (20.4) | 8 (19) | 8 (19) | ||
Previous abdominal operation, n (%) | 13 (17.1) | 13 (26.5) | 0.205 | 6 (14.3) | 10 (23.8) | 0.266 |
Neoadjuvant chemotherapy, n (%) | 5 (6.6) | 2 (4.1) | 0.704 | 4 (9.5) | 2 (4.8) | 0.676 |
Concurrent illness, n (%) | 34 (44.7) | 14 (28.6) | 0.070 | 18 (42.9) | 13 (31.0) | 0.258 |
Table 2 Operative findings
Variable | All patients | Propensity-matched patients | ||||
Drain (n = 76) | No drain (n = 49) | P value | Drain (n = 42) | No drain (n = 42) | P value | |
Operation time (min) | 198.4 ± 41.0 | 164.0 ± 37.0 | < 0.001 | 180.2 ± 33.4 | 168.0 ± 36.7 | 0.113 |
Estimated blood loss (mL) | 85.3 ± 80.7 | 70.82 ± 51.5 | 0.267 | 72.9 ± 45.8 | 73.8 ± 54.4 | 0.931 |
Intraoperative blood transfusion, n (%) | 2 (2.6) | 2 (4.1) | 0.645 | 1 (2.4) | 2 (4.8) | 1.000 |
Tumor size (cm) | 3.5 ± 1.6 | 3.6 ± 1.5 | 0.664 | 3.6 ± 1.7 | 3.5 ± 1.4 | 0.839 |
No. of retrieved lymph nodes | 36.7 ± 13.7 | 39.1 ± 14.2 | 0.346 | 40.0 ± 11.2 | 40.0 ± 15.1 | 0.923 |
Table 3 Recovery
Variable | All patients | Propensity-matched patients | ||||
Drain (n = 76) | No drain (n = 49) | P value | Drain (n = 42) | No drain (n = 42) | P value | |
Time to ambulation, POD | 2.51 ± 1.34 | 2.98 ± 1.39 | 0.064 | 2.90 ± 1.54 | 3.07 ± 1.44 | 0.610 |
Time to first flatus, POD | 3.97 ± 1.24 | 3.55 ± 1.79 | 0.122 | 4.33 ± 1.24 | 3.57 ± 1.85 | 0.029 |
Time to first eating of soft diet, POD | 4.70 ± 2.17 | 4.14 ± 2.09 | 0.159 | 5.02 ± 1.88 | 4.17 ± 2.20 | 0.058 |
Postoperative hospital stay | 7.88 ± 3.96 | 6.73 ± 5.13 | 0.164 | 7.93 ± 4.98 | 6.81 ± 5.50 | 0.331 |
CRP | 7.54 ± 4.38 | 8.53 ± 5.91 | 0.286 | 7.66 ± 3.89 | 8.71 ± 5.95 | 0.339 |
Tmax | 37.6 ± 0.5 | 37.5 ± 0.4 | 0.239 | 37.60 ± 0.60 | 37.48 ± 0.40 | 0.300 |
Table 4 Postoperative complications
All patients | Propensity-matched patients | |||||
Complication, n | Drain (n = 76), n (%) | No drain (n = 49), n (%) | P value | Drain (n = 42), n (%) | No drain (n = 42), n (%) | P value |
Total | 12(15.8) | 5 (10.2) | 0.374 | 8 (19.0) | 4 (9.5) | 0.212 |
Clavien–Dindo grade II | 4 (5.2) | 2 (4.0) | 3 (7.2) | 1 (2.4) | ||
Incision | 1 (1.3) | 1 (2.0) | 0 (0.0) | 0 (0.0) | ||
System complications | 1 (1.3) | 1 (2.0) | 1 (2.4) | 1 (2.4) | ||
Abdominal effusion | 2 (2.6) | 0 (0.0) | 2 (4.8) | 0 (0.0) | ||
Clavien–Dindo grade III | 8 (10.6) | 3 (6.0) | 5 (12) | 3 (7.2) | ||
Duodenal stump leakage | 2 (2.6) | 0 (0.0) | 2 (2.4) | 0 (0.0) | ||
Anastomotic Leakage | 2 (2.6) | 0 (0.0) | 0 (0.0) | 0 (0.0) | ||
Intra-abdominal bleeding | 1 (1.3) | 0 (0.0) | 1 (2.4) | 0 (0.0) | ||
Intra-abdominal abscess | 3 (3.9) | 2 (4.0) | 2 (2.4) | 2 (2.4) | ||
Pleural effusion | 0 (0.0) | 1 (2.0) | 0 (0.0) | 1 (2.4) | ||
Mortality | 0 (0.0) | 0 (0.0) | 1 | 0 (0.0) | 0 (0.0) | 1 |
Table 5 Risk assessment for the occurrence of postoperative complication
Variable | Postoperative complications (+) (n = 17) | Postoperative complications (-) (n = 108) | P value |
Sex | 0.584 | ||
Male | 13 | 74 | |
Female | 4 | 34 | |
Age | 59.59 ± 9.62 | 55.70 ± 11.30 | 0.182 |
BMI (kg/m2), n (%) | 27.44 ± 3.92 | 24.25 ± 3.53 | 0.001 |
≥ 29 | 5 (38.5) | 10 (13.3) | 0.042 |
< 29 | 8 (61.5) | 65 (86.7) | |
ASA (1/2/3), n (%) | 0.769 | ||
1 | 0 (0.0) | 1 (100.0) | |
2 | 15 (13.2) | 99 (86.8) | |
3 | 2 (20.0) | 8 (80.0) | |
Preoperative ALB (g) | 39.62 ± 4.65 | 40.18 ± 5.86 | 0.709 |
Preoperative HGB (g/L) | 136.59 ± 17.77 | 135.26 ± 19.36 | 0.791 |
pT stage, n (%) | 0.776 | ||
T1 | 7 (38.5) | 56 (49.3) | |
T2 | 4 (23.1) | 17 (20.0) | |
T3 | 3 (15.4) | 11 (8.0) | |
T4a | 3 (23.1) | 23 (22.7) | |
pN stage, n (%) | 0.872 | ||
N0 | 8 (38.5) | 46 (45.3) | |
N1 | 3 (15.4) | 25 (22.7) | |
N2 | 3 (23.1) | 18 (13.3) | |
N3 | 3 (23.1) | 19 (18.7) | |
Previous abdominal operation | 0.103 | ||
Yes | 1 | 25 | |
No | 16 | 83 | |
Neoadjuvant chemotherapy | 0.234 | ||
Yes | 2 | 5 | |
No | 15 | 103 | |
Concurrent illness | 0.800 | ||
Yes | 7 | 41 | |
No | 10 | 67 | |
Drain, n (%) | 12 (15.8) | 64 (84.2) | 0.374 |
No drain, n (%) | 5 (10.2) | 44 (89.8) | |
Type of reconstruction, n (%) | 0.357 | ||
Billroth I | 4 (30.8) | 32 (36.0) | |
Billroth II | 10 (61.5) | 69 (64.0) | |
Roux-en-Y | 3 (7.7) | 7 (0.0) | |
Operative time (min) | 195.82 ± 49.12 | 183.16 ± 41.69 | 0.258 |
Blood loss (mL) | 62.94 ± 42.54 | 82.22 ± 74.07 | 0.298 |
- Citation: Liu H, Jin P, Quan X, Xie YB, Ma FH, Ma S, Li Y, Kang WZ, Tian YT. Feasibility of totally laparoscopic gastrectomy without prophylactic drains in gastric cancer patients. World J Gastroenterol 2021; 27(26): 4236-4245
- URL: https://www.wjgnet.com/1007-9327/full/v27/i26/4236.htm
- DOI: https://dx.doi.org/10.3748/wjg.v27.i26.4236