title: Do All Patients Require Prophylactic Drainage After Gastrectomy for Gastric Cancer? The Experience of a High-Volume Center.
abstract: BACKGROUND
  Although our previous randomized controlled trial showed that there was no difference in postoperative complications after gastric cancer surgery between patients with and without a prophylactic drains (PDs), PDs are commonly used by most surgeons and at most institutions. However, these results have not yet been validated elsewhere. The purpose of this study was to analyze the incidence, characteristics, and risk factors for a postoperative percutaneous catheter drainage (PCD) procedure after gastric cancer surgery when PDs were not used.
  
  
  METHODS
  We reviewed data from 1989 patients who underwent gastrectomy with lymphadenectomy for gastric cancer with curative intent from January 2012 to December 2013.
  
  
  RESULTS
  The incidence of PCD in the abdomen was 1.8 % (22/1249) and 9.1 % (67/740) in patients with and without PD, respectively. In the without-PD group, age [odds ratio (OR) 1.032; p = 0.013], male gender (OR for female 0.38; p = 0.005), open surgery (OR for minimally invasive surgery 0.16; p = 0.013), and longer operative time (OR 1.01; p < 0.001) were independent risk factors for postoperative PCD in the abdomen. In the without-PD group, no microbes were detected in the peritoneal fluid obtained by PCD in 72.1 % (44/61) of patients who underwent PCD, and the most commonly identified organisms were Escherichia coli and Candida albicans.
  
  
  CONCLUSIONS
  Not using a PD increased the risk of PCD postoperatively, but no microbes in peritoneal fluid were detected in the most patients. Selective use of PD in patients during gastric cancer surgery may be possible using our risk factor analysis.
authors.affiliation: Department of Surgery, Yonsei University Health System, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Janghee
authors.initials: J
authors.lastname: Lee
authors.affiliation: Department of Surgery, Yonsei University Health System, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Yoon Young
authors.initials: YY
authors.lastname: Choi
authors.affiliation: Department of Surgery, Yonsei University Health System, Yonsei University College of Medicine, Seoul, Republic of Korea. JAR319@yuhs.ac.
authors.forename: Ji Yeong
authors.initials: JY
authors.lastname: An
authors.affiliation: Department of Surgery, Yonsei University Health System, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Sang Hyuk
authors.initials: SH
authors.lastname: Seo
authors.affiliation: Biostatistics Collaboration Unit, Yonsei University Health System, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Dong Wook
authors.initials: DW
authors.lastname: Kim
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Republic of Korea.
authors.forename: Yu Bin
authors.initials: YB
authors.lastname: Seo
authors.affiliation: Department of Surgery, Yonsei University Health System, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Nakagawa
authors.affiliation: Department of Surgery, Yonsei University Health System, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Shuangxi
authors.initials: S
authors.lastname: Li
authors.affiliation: Department of Surgery, Yonsei University Health System, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Jae-Ho
authors.initials: JH
authors.lastname: Cheong
authors.affiliation: Department of Surgery, Yonsei University Health System, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Woo Jin
authors.initials: WJ
authors.lastname: Hyung
authors.affiliation: Department of Surgery, Yonsei University Health System, Yonsei University College of Medicine, Seoul, Republic of Korea.|Brain Korea 21 PLUS Project for Medical Science, Yonsei University Health System, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Sung Hoon
authors.initials: SH
authors.lastname: Noh
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001202:Ascitic Fluid / Q000382:microbiology; D004322:Drainage / Q000706:statistics & numerical data*; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects* / Q000379:methods; D061847:Hospitals, High-Volume; D006801:Humans; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011182:Postoperative Care / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control; D012307:Risk Factors; D012737:Sex Factors; D013274:Stomach Neoplasms / Q000601:surgery*; D055815:Young Adult