Should a Drain Be Routinely Required After Transperitoneal Robotic Partial Nephrectomy?

Beksaç, Alp Tuna; Okhawere, Kennedy; Meilika, Kirolos; Ige, Olajumoke; Lee, Jennifer Y.; Lovallo, Gregory; Ahmed, Mutahar; Stifelman, Michael; Eun, Daniel; Abaza, Ronney; Badani, Ketan K.

doi:10.1089/end.2020.0325

Cited by 11 publications

(6 citation statements)

References 18 publications

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“…In the first such report, Godoy et al [7] omitted drains in 14.6% of 75 open partial nephrectomies. A multi-institutional series of 904 robotassisted partial nephrectomies found no increased complications in the nearly 40% who were treated by surgeons avoiding drains [8]. We omitted drains in 97% of cases, with only 3/604 urine leaks, suggesting that surgeons with rare urine leaks can omit drains much more frequently than current norms.…”

mentioning

confidence: 70%

Drains are not necessary in the majority of robot‐assisted urological procedures

Abaza¹,

Martínez²,

Murphy³

2022

BJU International

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mentioning

confidence: 70%

Drains are not necessary in the majority of robot‐assisted urological procedures

Abaza¹,

Martínez²,

Murphy³

2022

BJU International

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“…Despite the large sample size, patients in the drain group had favorable characteristics compared to the “tubeless” patients, such as lower BMI and ASA score, and smaller and lower complexity masses. These aspects could have influenced the results observed 12 . Peyronnet et al retrospectively compared 140 patients without abdominal drain insertion to 496 patients who had drain placed after RAPN.…”

Section: Discussionmentioning

confidence: 97%

Assessing the perioperative outcomes of abdominal drain omission after robot-assisted partial nephrectomy

Ditonno,

Bertolo,

Veccia

et al. 2024

Sci Rep

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The study aimed to evaluate the impact of abdominal drain placement (vs. omission) on perioperative outcomes of robot-assisted partial nephrectomy (RAPN), focusing on complications, time to canalization, deambulation, and pain management. A prospectively-maintained institutional database was queried to get data of patients who underwent RAPN for renal masses between January 2018 and May 2023 at our Institution. Baseline, surgical, and postoperative data were collected. Retrieved patients were stratified based upon placement of abdominal drain (Y/N). Descriptive analyses comparing the two groups were conducted as appropriate.77 After adjusting for potential confounders, a logistic regression analysis was conducted to evaluate significant predictors of any grade and “major” complications. 342 patients were included: 192 patients in the “drain group” versus 150 patients in the “no-drain” group. Renal masses were larger (p < 0.001) and at higher complexity (RENAL score, p = 0.01), in the drain group. Procedures in the drain group had statistically significantly longer operative time, ischemia time, and higher blood loss (all p-values < 0.001). The urinary collecting system was more likely involved compared to the no-drain group (p = 0.01). At multivariate analysis, abdominal drainage was not a significant predictor of any grade (OR 0.79, 95%CI 0.33–1.87) and major postoperative complications (OR 3.62, 95%CI 0.53–9.68). Patients in the drain group experienced a statistically significantly higher hemoglobin drop (p < 0.01). Moreover, they exhibited statistically significant higher paracetamol consumption (p < 0.001) and need for additional opioids (p = 0.02). In summary, the study results suggest the safety of omitting drain placement and remark on the need for personalized decision-making, which considers patient and procedural factors.

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“…In general, a single overnight stay is achievable in most patients undergoing RAPN [39] . The omission of a drain in most cases is another factor that might have contributed to this trend of reduced LOS [40] .…”

Section: Discussionmentioning

confidence: 98%

Retroperitoneal Robot-assisted Partial Nephrectomy: A Systematic Review and Pooled Analysis of Comparative Outcomes

Carbonara

Crocerossa

Campi

et al. 2022

European Urology Open Science

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Should a Drain Be Routinely Required After Transperitoneal Robotic Partial Nephrectomy?

Cited by 11 publications

References 18 publications

Drains are not necessary in the majority of robot‐assisted urological procedures

Drains are not necessary in the majority of robot‐assisted urological procedures

Assessing the perioperative outcomes of abdominal drain omission after robot-assisted partial nephrectomy

Retroperitoneal Robot-assisted Partial Nephrectomy: A Systematic Review and Pooled Analysis of Comparative Outcomes

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