Prophylactic drainage versus non-drainage following gastric cancer surgery: a meta-analysis of randomized controlled trials and observational studies

Pang, Hua-Yang; Chen, Li-Hui; Chen, Xiu-Feng; Yan, Meng-Hua; Chen, Zhi-Xiong; Sun, Hao

doi:10.1186/s12957-023-03054-1

Table 2 Perioperative outcomes of gastric cancer patients between the PD and ND groups

From: Prophylactic drainage versus non-drainage following gastric cancer surgery: a meta-analysis of randomized controlled trials and observational studies

Variables	Study design	Studies, n	Patients, n	OR or MD (95%CI)	P value	I² (%)	Publication bias (Begg’s P value)	Quality of evidence (GRADE)
Total complications	RCT	7	783	0.68 (0.47–0.98)	0.04	0
	Observational	11	2146	0.87 (0.69–1.11)	0.26	0
	Total	18	2929	0.81 (0.66–0.99)	0.04	0	0.600	Low ^a
Anastomotic leakage	RCT	4	383	0.62 (0.15–2.49)	0.50	0
	Observational	11	4010	0.95 (0.56–1.62)	0.76	0
	Total	15	4393	0.90 (0.55–1.48)	0.69	0	0.755	Low ^a
Duodenal stump leakage	RCT	2	168	0.33 (0.05–2.22)	0.25	0
	Observational	5	674	1.06 (0.21–5.34)	0.94	9
	Total	7	842	0.67 (0.20–2.22)	0.51	0	-	Very low ^a, ^e
Pancreatic leakage	RCT	1	60	0.30 (0.01–7.70)	0.47	-
	Observational	5	1301	0.61 (0.19–1.93)	0.40	18
	Total	6	1361	0.56 (0.21–1.49)	0.25	0	-	Very low ^a, ^e
Intra-abdominal abscess	RCT	4	445	0.72 (0.25–2.04)	0.53	0
	Observational	7	1219	1.26 (0.65–2.43)	0.50	0
	Total	11	1664	1.07 (0.61–2.43)	0.81	0	0.451	Low ^a
Surgical-site infection	RCT	5	593	0.77 (0.38–1.54)	0.45	0
	Observational	7	1292	0.72 (0.40–1.32)	0.29	0
	Total	12	1885	0.74 (0.47–1.17)	0.20	0	0.542	Low ^a
Pulmonary infection	RCT	5	545	0.95 (0.39–2.28)	0.90	0
	Observational	7	1055	0.80 (0.44–1.45)	0.46	0
	Total	12	1600	0.84 (0.51–1.38)	0.50	0	0.502	Low ^a
Need for additional drainage	RCT	2	278	1.07 (0.15–7.38)	0.95	0
	Observational	3	2411	1.67 (0.38–7.23)	0.49	85
	Total	5	2689	1.49 (0.45–4.90)	0.51	73	-	Very low ^a, ^b, ^e
Time to first soft diet	RCT	4	438	− 0.27 (− 0.55–0.00)	0.05	0
	Observational	6	698	− 0.78 (− 1.32 to − 0.24)	0.005	74
	Total	10	1136	− 0.54 (− 0.85 to − 0.23)	0.0007	56	0.119	Very low ^a, ^b
Length of hospital stay	RCT	6	716	− 0.98 (− 1.71 to − 0.26)	0.007	40
	Observational	12	2303	− 0.43 (− 1.08–0.21)	0.19	61
	Total	18	3019	− 0.63 (− 1.14 to − 0.12)	0.02	60	0.529	Very low ^a, ^b
Reoperation	RCT	2	168	0.64 (0.23–1.84)	0.41	25
	Observational	5	1146	0.57 (0.29–1.14)	0.11	0
	Total	7	1314	0.61 (0.35–1.04)	0.07	0	-	Very low ^a, ^e
Readmission	RCT	0	0	-	-	-
	Observational	3	950	1.47 (0.87–2.47)	0.15	0
	Total	3	950	1.47 (0.87–2.47)	0.15	0	-	Very low ^a, ^e
Mortality	RCT	4	416	1.30 (0.14–11.92)	0.82	25
	Observational	9	1881	0.56 (0.24–1.29)	0.17	0
	Total	13	2297	0.65 (0.30–1.40)	0.27	0	-	Low ^a

Downgrade quality of evidence: a: risk of bias; b: inconsistency; c: indirectness; d: imprecision; e: publication bias. Upgrade quality of evidence: f: large effect; g: plausible confounding would change the effect; h: dose–response gradient. OR Odds ratio, MD Mean difference, CI Confidence interval

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