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Current practice on the use of prophylactic drain after gastrectomy in Italy: the Abdominal Drain in Gastrectomy (ADiGe) survey

2022; Springer Science+Business Media; Volume: 74; Issue: 6 Linguagem: Inglês

10.1007/s13304-022-01397-0

2038-3312

Valentina Mengardo, Jacopo Weindelmayer, Alessandro Veltri, Simone Giacopuzzi, Lorena Torroni, Giovanni De Manzoni, Ferdinando Agresta, Rita Alfieri, Sergio Alfieri, Nicola Antonacci, Gian Luca Baiocchi, Lapo Bencini, Maria Bencivenga, Michele Benedetti, Mattia Berselli, Alberto Biondi, Gabriella Teresa Capolupo, Fabio Carboni, Riccardo Casadei, Francesco Casella, Marco Catarci, Paolo Cerri, Damiano Chiari, Eugenio Cocozza, Giovanni Colombo, Luca Cozzaglio, Giorgio Dalmonte, Maurizio Degiuli, Maurizio De Luca, Raffaele De Luca, Nicolò de Manzini, Carlo Alberto De Pasqual, Stefano De Pascale, Nicola De Ruvo, Mariantonietta Di Cosmo, Alberto Di Leo, M. Di Paola, Amedeo Elio, Francesco Ferrara, Giovanni Ferrari, Valentino Fiscon, Uberto Fumagalli, Gianluca Garulli, Andrea Gennai, Irene Gentile, Paola Germani, Monica Gualtierotti, Francesca Guerini, Angela Gurrado, Marco Inama, Filippo La Torre, E. Laterza, Pasquale Losurdo, Antonio Macrì, Alessandra Marano, Luigi Marano, Federico Marchesi, Fabio Marino, Marco Massani, Roberta Menghi, Marco Milone, Sarah Molfino, Mauro Montuori, Gianluigi Moretto, Paolo Morgagni, Emilio Morpurgo, Moukchar Abdallah, Luca Nespoli, Stefano Olmi, Raffaéle Palaia, Giovanni Pallabazer, Paolo Parise, Alessandro Pasculli, Marco Pericoli Ridolfini, Antonio Pesce, Enrico Pinotti, Michele Pisano, Elia Poiasina, Vittorio Postiglione, Stefano Rausei, Antonio Rella, Fausto Rosa, Riccardo Rosati, Gianmaria Rossi, Luca Rossit, Massimo Rovatti, Laura Ruspi, Luca Sacco, Edoardo Saladino, Andrea Sansonetti, Alberto Sartori, Donatella Scaglione, Stefano Scaringi, Christian Schoenthaler, Giuseppe Sena, Michele De Simone, Leonardo Solaini, Paolo Strignano, Nicola Tartaglia, Silvio Testa, Mario Testini, Guido Alberto Massimo Tiberio, Elio Treppiedi, Alessio Vagliasindi, Michele Valmasoni, Jacopo Viganò, Gianpietro Zanchettin, Andrea Zanoni, Claudio Zardini, A Zerbinati,

Esophageal and GI Pathology

Abstract Evidence against the use of prophylactic drain after gastrectomy are increasing and ERAS guidelines suggest the benefit of drain avoidance. Nevertheless, it is unclear whether this practice is still widespread. We conducted a survey among Italian surgeons through the Italian Gastric Cancer Research Group and the Polispecialistic Society of Young Surgeons, aiming to understand the current use of prophylactic drain. A 28-item questionnaire-based survey was developed to analyze the current practice and the individual opinion about the use of prophylactic drain after gastrectomy. Groups based on age, experience and unit volume were separately analyzed. Response of 104 surgeons from 73 surgical units were collected. A standardized ERAS protocol for gastrectomy was applied by 42% of the respondents. Most of the surgeons, regardless of age, experience, or unit volume, declared to routinely place one or more drain after gastrectomy. Only 2 (1.9%) and 7 surgeons (6.7%) belonging to high volume units, do not routinely place drains after total and subtotal gastrectomy, respectively. More than 60% of the participants remove the drain on postoperative day 4–6 after performing an assessment of the anastomosis integrity. Interestingly, less than half of the surgeons believe that drain is the main tool for leak management, and this percentage further drops among younger surgeons. On the other hand, drain’s role seems to be more defined for duodenal stump leak treatment, with almost 50% of the surgeons recognizing its importance. Routine use of prophylactic drain after gastrectomy is still a widespread practice even if younger surgeons are more persuaded that it could not be advantageous.