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Cochrane Database of Systematic Reviews

Abdominal drainage versus no drainage post-gastrectomy for gastric cancer

Overview of attention for article published in Cochrane database of systematic reviews, May 2015
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Title
Abdominal drainage versus no drainage post-gastrectomy for gastric cancer
Published in
Cochrane database of systematic reviews, May 2015
DOI 10.1002/14651858.cd008788.pub3
Pubmed ID
Authors

Zhen Wang, Junqiang Chen, Ka Su, Zhiyong Dong

Abstract

Gastrectomy remains the primary therapeutic method for resectable gastric cancer. Thought of as an important measure to reduce post-operative complications and mortality, abdominal drainage has been used widely after gastrectomy for gastric cancer in previous decades. The benefits of abdominal drainage have been questioned by researchers in recent years. The objectives of this review were to assess the benefits and harms of routine abdominal drainage post-gastrectomy for gastric cancer. We searched the Cochrane Upper Gastrointestinal and Pancreatic Diseases (UGPD) Group Specialised Register and the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library (2014, Issue 11); MEDLINE (via PubMed) (1950 to November 2014); EMBASE (1980 to November 2014); and the Chinese National Knowledge Infrastructure (CNKI) Database (1979 to November 2014). We included randomised controlled trials (RCTs) comparing an abdominal drain versus no drain in patients who had undergone gastrectomy (not considering the scale of gastrectomy and the extent of lymphadenectomy); irrespective of language, publication status, and the type of drain. We excluded RCTs comparing one drain with another. We adhered to the standard methodological procedures of The Cochrane Collaboration. From each included trial, we extracted the data on the methodological quality and characteristics of the participants, mortality (30-day mortality), re-operations, post-operative complications (pneumonia, wound infection, intra-abdominal abscess, anastomotic leak, drain-related complications), operation time, length of post-operative hospital stay, and initiation of a soft diet. For dichotomous data, we calculated the risk ratio (RR) and 95% confidence interval (CI). For continuous data, we calculated mean difference (MD) and 95% CI. We tested heterogeneity using the Chi(2) test. We used a fixed-effect model for data analysis with RevMan software, but we used a random-effects model if the P value of the Chi(2) test was less than 0.1. We included four RCTs involving 438 patients (220 patients in the drain group and 218 in the no-drain group). There was no evidence of a difference between the two groups in mortality (RR 1.73, 95% CI 0.38 to 7.84); re-operations (RR 2.49, 95% CI 0.71 to 8.74); post-operative complications (pneumonia: RR 1.18, 95% CI 0.55 to 2.54; wound infection: RR 1.23, 95% CI 0.47 to 3.23; intra-abdominal abscess: RR 1.27, 95% CI 0.29 to 5.51; anastomotic leak: RR 0.93, 95% CI 0.06 to 14.47); or initiation of soft diet (MD 0.15 days, 95% CI -0.07 to 0.37). However, the addition of a drain prolonged the operation time (MD 9.07 min, 95% CI 2.56 to 15.57) and post-operative hospital stay (MD 0.69 day, 95% CI 0.18 to 1.21) and led to drain-related complications. Additionally, we should note that 30-day mortality and re-operations are very rare events and, as a result, very large numbers of patients would be required to make any sensible conclusions about whether the two groups were similar. The overall quality of the evidence according to the GRADE approach was 'very low' for mortality and re-operations, and 'low' for post-operative complications, operation time, and post-operative length of stay. We found no convincing evidence to support routine drain use after gastrectomy for gastric cancer.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 185 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 185 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 24 13%
Student > Ph. D. Student 17 9%
Student > Postgraduate 14 8%
Other 13 7%
Researcher 13 7%
Other 46 25%
Unknown 58 31%
Readers by discipline Count As %
Medicine and Dentistry 63 34%
Nursing and Health Professions 26 14%
Unspecified 5 3%
Psychology 5 3%
Social Sciences 4 2%
Other 18 10%
Unknown 64 35%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 08 December 2015.
All research outputs
#17,756,606
of 22,803,211 outputs
Outputs from Cochrane database of systematic reviews
#11,280
of 12,315 outputs
Outputs of similar age
#179,527
of 264,398 outputs
Outputs of similar age from Cochrane database of systematic reviews
#240
of 264 outputs
Altmetric has tracked 22,803,211 research outputs across all sources so far. This one is in the 19th percentile – i.e., 19% of other outputs scored the same or lower than it.
So far Altmetric has tracked 12,315 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 30.4. This one is in the 7th percentile – i.e., 7% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 264,398 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 27th percentile – i.e., 27% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 264 others from the same source and published within six weeks on either side of this one. This one is in the 7th percentile – i.e., 7% of its contemporaries scored the same or lower than it.