[Efficacy and safety of abdominal drainage after gastrectomy for gastric cancer patients: a systematic review].

Objective: To assess the efficacy and safety of gastrectomy abdominal drainage after gastrectomy in gastric cancer patients.

Methods: Cochrane systematic evaluation was used to search through Cochrane library (2007-No.3) of clinical comparative trail, PubMed (1976-2008), Embase (1982-2008), Chinese Biomedical Literature Database (CBM 1979-2008), Chinese Scientific Journal Full-text Database (CSJD 1989-2008) and Chinese Journal Full-text Database (CJFD1994-2008), aided with manual retrieval and other retrievals. The quality of the assessment was independently evaluated and cross-checked by two evaluators. The results of homogeneous studies were analyzed with RevMan4.2.10 software.

Results: A total of 47 articles were retrieved. Three randomized controlled trials were involved. A total of 338 patients were studied. Of the 338 patients, 160 were treated with total gastrectomy, 178 subtotal gastrectomy. Among the 338 patients, 167 were treated without abdominal drainage. Above 3 trials did not report blind method and did not describe method of allocation concealment. No significant differences were found in pulmonary complication, wound infection, intra-abdominal abscess, clinical leakage and initiation of soft diet between abdominal drainage group and without abdominal drainage group. Statistical results showed odds ratio (OR)=1.23, 95% CI=0.49-3.07 for pulmonary complication; OR=1.09, 95% CI=0.36-3.29 for wound infection; OR=1.28, 95% CI=0.28-5.8 for intra-abdominal abscess; OR=1.53, 95% CI=0.25-9.42 for anastomotic leakage; OR=1.78, 95% CI=0.37-8.56 for hospital mortality; WMD=0.12, 95% CI=-0.11-0.35 for initiation of soft diet. Besides, significant difference was found in hospital stay (WMD=0.65, 95% CI=0.03-1.26), and abdominal drainage group was longer.

Conclusion: Abdominal drainage after gastrectomy should not be recommended as a regular treatment for gastric cancer patients.