Background: The optimal timing of the drain removal after gastrectomy has been unclear. The aim of this prospective randomized controlled study was to assess the optimal timing of removal of prophylactic drains after distal gastrectomy (DG) or pylorus-preserving gastrectomy (PPG). Methods: All patients undergoing DG or PPG for gastric cancer were eligible for this study. The exclusion criteria were combined organ resection, the use of postoperative anticoagulant therapy, intraoperative injury of other organs and anastomotic problems. Just after the operation, the eligible patients were randomly assigned to either the early removal group (n=50), where the drain was removed in the morning of the postoperative day (POD) 1, or the control group (n=50), where the drain was removed on POD 3 or later. We compared the surgical outcomes between the groups. Results: The rate of overall postoperative complications was 18% in the early removal group and 18% in the control group, with no significant difference between the groups. The severity of complications was also similar between the groups. There were no significant differences between the groups with regard to the postoperative recovery, pain or the length of the postoperative hospital stay. Conclusions: The present study demonstrated the safety and feasibility of the early removal of prophylactic drains in selected patients undergoing DG or PPG for gastric cancer
