PreprintArticleVersion 1This version is not peer-reviewed
The Drain Debate: A Prospective Controlled Trial on Criteria-Based Prophylactic Drain Use in Total Gastrectomy for Esophagogastric Junctional or Gastric Cancer (The DRAG Study)
Version 1
: Received: 5 November 2024 / Approved: 5 November 2024 / Online: 6 November 2024 (12:33:47 CET)
How to cite:
Eleftheriou, M. M.; Doulberis, M.; Pouliakis, A.; Kareklas, D.; Toutouzas, K.; Zografos, G.; Theodorou, D.; Triantafyllou, T. The Drain Debate: A Prospective Controlled Trial on Criteria-Based Prophylactic Drain Use in Total Gastrectomy for Esophagogastric Junctional or Gastric Cancer (The DRAG Study). Preprints2024, 2024110343. https://doi.org/10.20944/preprints202411.0343.v1
Eleftheriou, M. M.; Doulberis, M.; Pouliakis, A.; Kareklas, D.; Toutouzas, K.; Zografos, G.; Theodorou, D.; Triantafyllou, T. The Drain Debate: A Prospective Controlled Trial on Criteria-Based Prophylactic Drain Use in Total Gastrectomy for Esophagogastric Junctional or Gastric Cancer (The DRAG Study). Preprints 2024, 2024110343. https://doi.org/10.20944/preprints202411.0343.v1
Eleftheriou, M. M.; Doulberis, M.; Pouliakis, A.; Kareklas, D.; Toutouzas, K.; Zografos, G.; Theodorou, D.; Triantafyllou, T. The Drain Debate: A Prospective Controlled Trial on Criteria-Based Prophylactic Drain Use in Total Gastrectomy for Esophagogastric Junctional or Gastric Cancer (The DRAG Study). Preprints2024, 2024110343. https://doi.org/10.20944/preprints202411.0343.v1
APA Style
Eleftheriou, M. M., Doulberis, M., Pouliakis, A., Kareklas, D., Toutouzas, K., Zografos, G., Theodorou, D., & Triantafyllou, T. (2024). The Drain Debate: A Prospective Controlled Trial on Criteria-Based Prophylactic Drain Use in Total Gastrectomy for Esophagogastric Junctional or Gastric Cancer (The DRAG Study). Preprints. https://doi.org/10.20944/preprints202411.0343.v1
Chicago/Turabian Style
Eleftheriou, M. M., Dimitrios Theodorou and Tania Triantafyllou. 2024 "The Drain Debate: A Prospective Controlled Trial on Criteria-Based Prophylactic Drain Use in Total Gastrectomy for Esophagogastric Junctional or Gastric Cancer (The DRAG Study)" Preprints. https://doi.org/10.20944/preprints202411.0343.v1
Abstract
Background: Total gastrectomy with D2 lymph node dissection is standard for resectable esophagogastric junctional and gastric cancer, but high morbidity challenges perioperative care. ERAS guidelines advise against routine drains, yet conflicting evidence leads to inconsistent practice.
Methods: The DRAG (DRains After Gastrectomy) Trial is a prospective, non-randomized study conducted from February 2020 to March 2023 at the 1st Propaedeutic Surgery Department, Hippocration General Hospital, Athens. Patients undergoing open D2 total gastrectomy had perianastomotic drains placed based on newly established criteria, offering a more tailored approach. Immediate and short-term postoperative outcomes, including recovery milestones and complications, were assessed.
Results: Sixty patients were included, with 40 receiving a drain. The non-drain group had significantly lower pain scores, earlier mobilization, less postoperative nausea and vomiting, and a shorter hospital stay. Among those with complications, significant differences in surgical site infections, delayed mobilization, extra-abdominal issues, length of stay, readmissions, and reoperations suggest that drain use may increase complications and hinder recovery.
Conclusion: Our study suggests that routine prophylactic drain use can be avoided in gastrectomy for esophagogastric junctional and gastric cancer when experienced surgeons in high-volume centers follow clearly defined criteria. Implementing these criteria may improve patient outcomes and reduce complications
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
