腹腔鏡補助下胃切除における予防的ドレーン留置の意義

Significance of prophylactic drain placement for laparoscopy-assisted gastrectomy

◆要旨：腹腔鏡補助下幽門側胃切除（以下，LADG）および幽門保存胃切除（以下，LAPPG）症例におけるドレーン留置の意義について検討した．対象と方法：2009年におけるLADG/PPG 228症例を対象として，ドレーン有群124例，無群104例の2群間で術後合併症，在院日数について比較検討した．結果：合併症発生率は13.9％，Grade 2以上（Clavien-Dindo分類）の発生率は8.3％で，ドレーン有群，無群との間に有意な差は認めなかった．術後在院日数は平均13.1日，有群vs無群は13.3 vs 13.0日で，やはり両群間に有意差を認めなかった．結論：LADG/PPGにおいてドレーン留置の有益性は見いだせなかった．

　Purpose : The purpose of this study is to determine the significance of prophylactic drain placement after laparoscopy-assisted distal gastrectomy （LADG） and pylorus-preserving gastrectomy （LAPPG）. Materials and Methods : Two hundred and twenty eight patients, who underwent LADG or LAPPG for early gastric cancer between January 2009 and December 2009, were divided into drain group （n＝124） and no-drain group （n＝104）. The incidence of post-operative complications and the duration of post-operative hospital stay were compared between the two groups. Results : The incidence of complications was encountered in 13.9％; that of grade 2 （Clavien-Dindo classification） or higher was in 8.3％. The average postoperative hospital stay was 13.1 days; that of drain-group vs. no-drain group was 13.3 vs 13.0. No significant differences were observed between the two groups in the incidence of post-operative complications and the duration of post-operative hospital stay. Conclusions : Prophylactic drain placement does not offer additional benefit for the patients with LADG or LAPPG.