Is Routine Placement of Surgical Drains Necessary After Elective Hepatectomy? Results From a Single Institution

Aldameh, Ali; McCall, John L.; Koea, Jonathan

doi:10.1016/j.gassur.2004.12.006

Cited by 42 publications

(29 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…To date, there is no evidence that abandoning prophylactic drainage increases the need for (radiological) reinterventions [11] . The RSR reintervention rate of 12% in this study demonstrates that a no-drain policy does not lead to more reinterventions, higher morbidity, or mortality compared to patients with a drain [1,4,5,7,8,12,13,27] .…”

Section: Discussionmentioning

confidence: 61%

“…level 1b evidence, 1 study [13] was grade level 2b evidence, and the remaining studies [5,12,[25][26][27] were cohort studies of grade 4 evidence. No ongoing studies could be identified in clinical trial registers.…”

Section: Literature Reviewmentioning

confidence: 99%

“…Some studies have reported advantages of prophylactic drain placement such as early drainage of bile leaks, preventing subphrenic collection, detecting postoperative hemorrhage, and removing ascites [3][4][5][6] . Other studies have indicated that the risks of prophylactic intra-abdominal drains, including drain-related bleeds, ascending intra-abdominal infections by retrograde contamination, and impaired pulmonary function, outweigh the benefits [1,7,8] .…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Abandoning Prophylactic Abdominal Drainage after Hepatic Surgery: 10 Years of No-Drain Policy in an Enhanced Recovery after Surgery Environment

et al. 2017

View full text Add to dashboard Cite

Background: Routine prophylactic abdominal drainage after hepatic surgery is still being debated, as it may be unnecessary, possibly harmful, and uncomfortable for patients. This study evaluated the safety of a no-drain policy after liver resection within an Enhanced Recovery after Surgery (ERAS) programme. Methods: All hepatectomies performed without prophylactic drainage during 2005-2014 were included. Primary end points were resection-surface-related (RSR) morbidity, defined as the presence of postoperative biloma, hemorrhage or abscess, and reinterventions. Secondary end points were length of stay, total postoperative morbidity, the composite end point of liver surgery-specific complications, readmissions, and 90-day mortality. Uni- and multivariate analyses were performed to identify independent risk factors for RSR morbidity. A systematic search was performed to compare the results of this study to literature. Results: A total of 538 resections were included in the study. The RSR complication and reintervention rate was 15 and 12%, respectively. Major liver resection (≥3 segments) was an independent risk factor for the development of RSR morbidity (OR 3.01, 95% CI 1.61-5.62; p = 0.001) and need for RSR reintervention (OR 3.02, 95% CI 1.59-5.73; p = 0.001). Conclusion: RSR morbidity, mortality, and reintervention rates after liver surgery without prophylactic drainage in patients, treated within an ERAS programme, were comparable to previously published data. A no-drain policy after partial hepatectomy seems safe and feasible.

show abstract

Section: Discussionmentioning

confidence: 61%

Section: Literature Reviewmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Abandoning Prophylactic Abdominal Drainage after Hepatic Surgery: 10 Years of No-Drain Policy in an Enhanced Recovery after Surgery Environment

et al. 2017

View full text Add to dashboard Cite

show abstract

“…In the future, attention should be paid to drain-related complications rather than those from surgical procedures, such as subcutaneous abscess at the drain site, seeding of tumor along the drain tract, and intra-abdominal abscess, fluid collection or fistula. These complications are directly related to the effectiveness of prophylactic placement of drains after gastrectomy [9,17,18,19]. …”

Section: Discussionmentioning

confidence: 99%

Drain versus No-Drain after Gastrectomy for Patients with Advanced Gastric Cancer: Systematic Review and Meta-Analysis

Liu

Zhang

et al. 2011

Dig Surg

View full text Add to dashboard Cite

Background and Objectives: A wide range of outcomes are seen in the literature on the use of drains after gastrectomy. However, there is little consensus on whether or not drains are beneficial in patients with gastric cancer. The purpose of this meta-analysis was to evaluate drain versus no-drain after gastrectomy by using evidence from available randomized controlled trials (RCTs). Methods: We searched PubMed, the Cochrane Library, Embase, VIP, and CNKI for the terms ‘gastric cancer’, ‘gastrectomy’ and ‘drains’ used in combination with the medical subject headings. RCTs were considered. Meta-analysis was performed by RevMan 5.0 software. Results: Four RCTs involving 438 patients were included. There were no differences between the drain and no-drain groups in the incidence of wound infection, postoperative pulmonary infection, intra-abdominal abscess, mortality, number of postoperative days until passing of flatus and initiation of soft diet. Both the incidence of postoperative complications and the length of hospital stay for patients in the no-drain group after gastrectomy were lower than in the drain group (p = 0.03, 95% CI 0.32, 0.95) and (p = 0.009, 95% CI –1.21, –0.18), respectively. Conclusion: Avoiding the use of abdominal drains may reduce drain-related complications and shorten hospital stay after gastrectomy.

show abstract

“…Studies showed that the use of a drain was not beneficial and may even be harmful, in terms of more wound complications, more septic complications and longer hospital stay 72,73 . Many centres have now stopped using the routine drainage after resections.…”

Section: Various Adjuncts In Hepatectomymentioning

confidence: 99%

Techniques for Liver Resection

Chowdhury

2011

Bangabandhu Sheikh Mujib Medical Univ J

View full text Add to dashboard Cite

Is Routine Placement of Surgical Drains Necessary After Elective Hepatectomy? Results From a Single Institution

Cited by 42 publications

References 15 publications

Abandoning Prophylactic Abdominal Drainage after Hepatic Surgery: 10 Years of No-Drain Policy in an Enhanced Recovery after Surgery Environment

Abandoning Prophylactic Abdominal Drainage after Hepatic Surgery: 10 Years of No-Drain Policy in an Enhanced Recovery after Surgery Environment

Drain versus No-Drain after Gastrectomy for Patients with Advanced Gastric Cancer: Systematic Review and Meta-Analysis

Techniques for Liver Resection

Contact Info

Product

Resources

About