Prophylactic Abdominal Drains

Nora, Paul F.; Vanecko, Robert M.; Bransfield, James J.

doi:10.1001/archsurg.1972.04180080027005

Cited by 110 publications

(47 citation statements)

References 7 publications

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“…The pain and fever disappeared spontaneously within 1-3 days and occurred in 23% of the group with drains and 4% in the group without drains [19]. This difference may be explained as follows: 1) the presence of a drain causes a foreign body reaction [20,21]; 2) the drain forms a connection between the peritoneal cavity and skin [22]; and 3) the feeling of discomfort produced by the drain prevents patients from coughing [12]. Similarly, Cruse and Foord established that wound site infection was five times more common in the group with drains than in the group without drains [23].…”

Section: Discussionmentioning

confidence: 99%

Is a Drain Required after Laparoscopic Cholecystectomy?

Gürer

Dumlu

Dikili

et al. 2013

EAJM

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Objective: Whether drains should be routinely used after laparoscopic cholecystectomy is still debated. We aimed to retrospectively evaluate the benefits of drain use after laparoscopic cholecystectomy for non-acute and non-inflamed gallbladders. Materials and Methods:Two hundred and fifty patients (mean age, 47±13.8 years; 200 females and 50 males) who underwent laparoscopic cholecystectomy for cholestasis were included in the study. The medical files of the patients were examined retrospectively to obtain data on patient demographics, cholecystitis attacks, complications during the operation, whether a drain was placed in the biliary tract during the operation, etc. The volume of the fluid collection detected in the subhepatic area by ultrasonography on the first postoperative day was recorded.Results: Drains were placed in 51 patients (20.4%). The mean duration of drain placement was 3.1±1.9 (range 1-16) days. Fluid collection was detected in the gallbladder area in 67 patients (26.8%). The mean volume of collected fluid was 8.8±5.2 mL. There were no significant effects of age, gender, and previous cholecystitis attacks on the presence or volume of the fluid collection (P>0.05 for all). With regard to the relationship between fluid collection and drains, 52 of 199 (26.1%) patients without drains had postoperative fluid collection, compared to 15 of 51 (29.4%) patients with drains (P>0.05). Conclusion:In conclusion, there is no relationship between the presence of a drain after laparoscopic cholecystectomy and the presence of postoperative fluid collection. Thus, in patients without complications, it is not necessary to place a drain to prevent fluid collection. Key Words: Laparoscopic cholecystectomy, drains, ultrasonography ÖzetAmaç: Laparoskopik kolesistektomi sonrası rutin olarak dren kullanı-mı hala üzerinde tartışılan bir konudur. Bu çalışmada akut olmayan noninflamatuar safra kesesi için uygulanan laparoskopik kolesistektomi sonrası dren kullanımının avantajlarını retrospektif olarak değerlendirmeyi amaçladık. Gereç ve Yöntem:Çalışmaya kolestaz nedeniyle laparoskopik kolesistektomi uygulanan 250 hasta (ortalama yaş, 47±13.8 yıl; 200 kadın ve 50 erkek) dahil edildi. Hasta dosyaları retrospektif olarak değerlen-dirilerek demografi, kolesistit atak, cerrahi komplikasyonlar, cerrahi sırasında biliar trakt üzerine dren yerleştirilme durumu v.b. üzerine veri toplandı. Postoperatif ilk gün ultrasonografide subhepatik alanda biriken sıvı hacmi kaydedildi. Bulgular:Hastaların 51'ine (%20.4) dren yerleştirildi. Ortalama dren kalış süresi 3.1±1.9 gün (aralık, 1-16 gün) idi. Altmış yedi (%26.8) hastada safra kesesi bölgesinde sıvı birikimi görüldü. Ortalama sıvı hacmi 8.8±5.2 mL idi. Sıvı birikimi varlığı ve hacmi üzerinde yaşın, cinsiyetin ve önceki kolesistit ataklarının etkisi yoktu (tümü için P>0.05). Sıvı birikimi ve dren arasındaki ilişki değerlendirildiğinde, dren takılma-yan 199 hastanın 52'sinde (%26.1) ve dren olan 51 hastanın 15'inde (%29.4) sıvı birikimi olduğu görüldü (P>0.05).Sonuç: Laparoskop...

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Section: Discussionmentioning

confidence: 99%

Is a Drain Required after Laparoscopic Cholecystectomy?

Gürer

Dumlu

Dikili

et al. 2013

EAJM

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“…8,9 There is controversy for prophylactic drain insertion after bariatric surgery, and some surgeons do not recommend it. However, most surgeons use a drain at the end of the operation for early diagnosis and treatment of complications, especially leakage or bleeding.…”

Section: Discussionmentioning

confidence: 99%

“…8 Drain usage is verified in laparoscopic cholecystectomy, and studies have shown that it is associated with postoperative pain. 9 Most surgeons recommend the use of a drain for all morbidly obese patients after gastric bypass surgery. 8 This study evaluated the possible association between the position of the drain site and postoperative pain, measuring its prevalence and severity after LGBP surgery.…”

Section: Introductionmentioning

confidence: 99%

Evaluating the Effect of Drain Site on Abdominal Pain after Laparoscopic Gastric Bypass Surgery for Morbid Obesity: A Randomized Controlled Trial

Eidy

Jamshidi

Raygan

et al. 2015

Bariatric Surgical Practice and Patient Care

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Background: Most morbidly obese patients complain of abdominal pain after laparoscopic gastric bypass (LGBP) surgery. In this study, the relationship between the prevalence and severity of pain and the drain site was assessed. Methods: Fifty morbidly obese patients undergoing LGBP surgery were selected, and a drain was randomly inserted postoperatively to the left 5 mm port in 25 cases and to the right in the other 25. All patients filled out a questionnaire, including a visual analog scale for the quality and quantity of pain, exacerbating and alleviating factors and its relation to patient's positioning, in the first 24 hours, first week, and first month after the operation. Result: In both groups, all patients had abdominal pain 24 hours after the operation. However, in the right-sided drain group, most patients (52%) experienced mild pain, whereas most patients (56%) in the left-sided drain group had severe pain ( p = 0.028). At weeks 1 and 4, there was no significant difference between the two groups in terms of severity of pain ( p = 0.068 and 0.875, respectively, for both times). After the first 24 hours and first week, the mean pain score was significantly lower in the right-sited drain group compared to the left-sited drain group ( p = 0.012 and 0.006). Conclusion: Early abdominal pain after LGBP surgery is significantly reduced in the right-sided drain group.

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“…There are surgeons who believe that drainage of peritoneal cavity is impossible, and therefore, prophylactic drainage is useless [15,16]. The surgeons who are opposed to drainage believe that it [17][18][19][20][21][22] (A) Actually stimulates the formation of serous fluid (B) Can lead to infection from outside (C) Increases the rate of leakage by preventing the mobilization of omentum and adjacent organs, obstructing their sealing action on suture line or even creating leakage by mechanical erosion of the anastomoses (D) Is walled off quickly Although there is a considerable theoretical and practical evidences in favor of drainage, the dispute about "to drain or not to drain" the peritoneal cavity after elective colorectal surgery remains open [23]. Anastomotic dehiscence is a serious complication leading to major mortality and morbidity of colorectal surgery [24].…”

Section: Drain Vs No Drainmentioning

confidence: 99%

To Drain or Not to Drain after Colorectal Cancer Surgery

Samaiya¹

2015

Indian J Surg

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Prophylactic drainage of abdominal cavity after GI surgery has been widely practiced. The most important signal function of prophylactic drain is to detect early complications. But the same drains could be the cause of some of the complications. Although there is a considerable theoretical and practical evidences in favor of drainage, the dispute about Bto drain or not to drain^the peritoneal cavity after elective colorectal surgery remains open. Unfortunately, the principle of drainage is not based on any scientific data. During the last three decades, surgeons have made efforts to investigate the value of prophylactic drainage after colorectal surgery. However, the results of trials are contradictory due to lack of quality and/or statistical power and therefore do not provide an answer to the clinical question. A systematic review of studies suggests that there is insufficient evidence for routine use of drain after colorectal surgery. Despite evidence-based data questioning prophylactic drainage of abdominal cavity in many instances, most surgeons around the world continue to use drains on a routine basis until now. There are strong evidences in literature in favor of no apparent benefit of drainage for supra-peritoneal anastomoses; however, there is still controversies regarding drainage of infra-peritoneal rectal anastomoses.

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Prophylactic Abdominal Drains

Cited by 110 publications

References 7 publications

Is a Drain Required after Laparoscopic Cholecystectomy?

Is a Drain Required after Laparoscopic Cholecystectomy?

Evaluating the Effect of Drain Site on Abdominal Pain after Laparoscopic Gastric Bypass Surgery for Morbid Obesity: A Randomized Controlled Trial

To Drain or Not to Drain after Colorectal Cancer Surgery

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