scholarly journals Is Prophylactic Abdominal Drainage Necessary After Laparoscopic Colectomy For Colon Cancer? A Propensity Score-Matched Analysis

2021 ◽  
Author(s):  
Le Huy Luu ◽  
Tran Van Hoi ◽  
Nguyen Van Hai ◽  
Nguyen Anh Dung ◽  
Do Dinh Cong ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Propensity Score ◽  
Hospital Stay ◽  
Laparoscopic Colectomy ◽  
Right Hemicolectomy ◽  
Postoperative Hospital Stay ◽  
Routine Practice ◽  
Middle Income ◽  
Prophylactic Drainage ◽  
Drain Group

Abstract Background: In 2018, the Enhanced Recovery After Surgery (ERAS) Society recommended against routine drainage after colorectal surgery. However, the evidence is relatively old and few studies were performed in low-to-middle income country (LMIC) setting. This study aimed to compare outcomes of laparoscopic colectomy with and without prophylactic drainage for colon cancer.Methods: A retrospective study was performed from 2018 to 2021 with patients who underwent laparoscopic colectomy with D3 lymphadenectomy for colon cancer. The use of prophylactic drainage was depended on routine practice of surgeons. Outcomes were postoperative complications and postoperative hospital length of stay. The drain and no-drain groups were compared using propensity score-matched (PSM) analysis.Results: The study included 143 patients (59 in the drain group and 84 in the no-drain group). The PSM resulted in 94 patients (47 in each group). Median age was 62 years. The most frequent was right hemicolectomy (33.6%), followed by left hemicolectomy (32.2%), sigmoid colectomy (21%), extended right hemicolectomy (9.8%), transverse hemicolectomy (2.1%), and total colectomy (1.4%). Postoperative hospital stay was significantly shorter in the no-drain group (median of 5 versus 6 days). The no-drain group also had lower rate of complications (23.8% versus 30.5% and 23.4% versus 34% before and after matching respectively) and less severe complications based on Clavien-Dindo classification, but the difference was not significant.Conclusions: Laparoscopic colectomy without prophylactic drainage is safe in the treatment of colon cancer. This approach can shorten postoperative hospital stay and should be applied even in the LMIC setting.Main novel aspect: Laparoscopic colectomy without prophylactic drainage for colon cancer can be applied in low-to-middle income settings.

scholarly journals Inappropriate manipulation and drainage exacerbate post-operative pain and prolong the hospital stay after laparoscopic appendectomy for pediatric complicated appendicitis

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yi-Wen Tsai ◽  
Shin-Yi Lee ◽  
Jyun-Hong Jiang ◽  
Jiin-Haur Chuang
Keyword(s):  
Hospital Stay ◽  
Laparoscopic Appendectomy ◽  
Pediatric Patients ◽  
Complicated Appendicitis ◽  
Postoperative Hospital Stay ◽  
Postoperative Outcomes ◽  
Chang Gung Memorial Hospital ◽  
Abdominal Abscess ◽  
Penrose Drain ◽  
Drain Group

Abstract Background This study examined whether drain placement or not is associated with the postoperative outcomes of pediatric patients following trans-umbilical single-port laparoscopic appendectomy (TUSPLA) for complicated appendicitis. Methods The medical records of pediatric patients undergoing TUSPLA for acute complicated appendicitis from January 2012 to September 2018 in Kaohsiung Chang Gung Memorial Hospital were reviewed retrospectively. They were classified according to whether they received passive drainage with a Penrose drain (Penrose group) (19), active drainage with a Jackson-Pratt drain with a vacuum bulb (JP group) (16), or no drain (non-drain group) (86). The postoperative outcomes of the three groups were compared. Results Postoperative visual analog scale pain score was significantly higher in the non-drain group than in either the JP group or Penrose group. Patients in the Penrose group had a significantly longer postoperative hospital stay than those in the non-drain group and a higher rate of intra-abdominal abscess, while patients in the JP group had a significantly shorter postoperative hospital stay; moreover, no patient in JP group developed a postoperative intra-abdominal abscess. Conclusions Compared to passive drainage with a Penrose drain or no drain, active drainage with a JP drain shorter the postoperative hospital stay and decreased the risk of postoperative intra-abdominal abscess.

Single‐port laparoscopic colectomy in elderly patients with colon cancer: A propensity score‐matched comparison with younger patients

2020 ◽  
Vol 13 (2) ◽  
pp. 175-179 ◽  
Author(s):  
Yasumitsu Hirano ◽  
Chikashi Hiranuma ◽  
Masakazu Hattori ◽  
Kenji Douden ◽  
Shigeki Yamaguchi
Keyword(s):  
Colon Cancer ◽  
Propensity Score ◽  
Elderly Patients ◽  
Laparoscopic Colectomy ◽  
Single Port ◽  
Younger Patients ◽  
Matched Comparison

scholarly journals Efficacy of Prophylactic Drain Placement in Laparoscopic Total Gastrectomy: A Retrospective Study

2020 ◽  
Vol 104 (1-2) ◽  
pp. 33-38 ◽  
Author(s):  
Akira Saito ◽  
Masahiko Murakami ◽  
Koji Otsuka ◽  
Kimiyasu Yamazaki ◽  
Masahiro Komoto ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Hospital Stay ◽  
Total Gastrectomy ◽  
Clinical Characteristics ◽  
Laparoscopic Total Gastrectomy ◽  
Postoperative Hospital Stay ◽  
Duration Of Hospital Stay ◽  
Significant Difference ◽  
Drain Group ◽  
Drain Placement

The aim of this study was to assess the efficacy of prophylactic drain placement in laparoscopic total gastrectomy (LTG). Ninety-four patients with gastric cancer who underwent LTG between December 2007 and December 2014 were enrolled in this study. A tube drain was placed in 29 patients after considering it necessary by operators, whereas no tube drain was placed in remaining patients. All patients were classified into either the drain or the no-drain group and were investigated for clinical characteristics and surgical outcomes. Overall, complications occurred in 15 patients and were not significantly different between the drain and no-drain groups [5 (17.2%) versus 10 (15.4%) patients]. No significant difference was observed in median duration of postoperative hospital stay between the drain and no-drain groups (12 versus 12 days). There was no significant difference in the duration of hospital stay regardless of the presence of drains in both groups of patients who developed complications (with drain: 27 days versus without drain: 21.5 days) and those who did not develop complications (with drain: 12 days versus without drain: 12 days). In conclusion, on the basis of the results of this study, routine prophylactic drain placement in LTG may not be necessary because it does not offer any additional benefits for patients.

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