The improved mediastinal drainage strategy for the enhanced recovery system after esophagectomy.

Abstract Background The improved drainage strategy was the transperitoneal placement of a single mediastinal drainage tube after esophagectomy. This study aimed to explore its effect on the incidence of postoperative complications, pain scores, and hospital stay. Methods Data from 108 patients underwent minimally invasive esophagectomy (MIE) was retrospectively analysed. Patients were divided into two groups: those in Group A were treated with transthoracic placement of mediastinal drain, Group B with transperitoneal placement. The incidence of postoperative complications, pain scores, and postoperative hospital stay were compared. Results The maximum pain scores in Group B were significantly lower than those in Group A from the first to the fourth postoperative days: (3.9±0.7) vs. (2.3±0.7), (3.5±0.8) vs. (2.1±0.7), (3.3±0.8) vs. (1.7±0.8) and (3.1±0.7) vs. (1.7±0.8) (all p 0.05). Conclusions The transperitoneal placement of a single mediastinal drain can reduce postoperative pain and the incidence of pleural effusion, without increasing the incidence of other major postoperative complications and postoperative hospital stay.