2019, Number 5
<< Back Next >>
Cir Cir 2019; 87 (5)
Use of drains and post-operative complications in secondary peritonitis for complicated acute appendicitis at a national hospital
Miranda-Rosales LM, Kcam-Mayorca EJ, Luna-Abanto J, Malpartida-Saavedra H, Flores-Flores C
Language: English
References: 17
Page: 540-544
PDF size: 130.10 Kb.
ABSTRACT
Introduction: Acute appendicitis is the main cause of emergency surgical care. Post-operative patients with complicated
acute appendicitis present complications, many of them expected. The use of drains is one of the measures to prevent these
complications; however, recent meta-analyzes do not justify this therapeutic measure. This study evaluates the relationship
between use and non-use of drains, post-operative complications in patients with complicated peritonitis secondary to acute
appendicitis.
Methods: A retrospective observational cohort study was conducted. The outcomes were analyzed by Chi-square
test and Student’s t-test; Fisher exact test was performed.
Results: The average operating time was 1.46 h (1.0-2.5) and
1.66 (1-3) for patients without drains and with drains, respectively, the difference was significant (p = 0.001). Post-operative
fever was more prevalent in group with a drains odds ratio (OR) 3.4 (confidence interval [CI] 95% 1.4-7.9). The mean time of
hospitalization was 7.3 (3-20) and 8.8 days (3-35) for patients without drains and with drains, respectively. (p = 0.01). The
Chi-square analysis was significant for evisceration Grade III and residual collection p = 0.036, OR not evaluable. Reoperation
was not significant among both groups, p = 0.108 OR 6.3 (CI 95% 0.6-62.4).
Conclusions: There is a relationship between
the non-use of drains and collections and evisceration in post-operative patients with open appendectomy, by complicated
acute appendicitis.
REFERENCES
Gorter RR, Eker HH, Gorter-Stam MA, Abis GS, Acharya A, Ankersmit M, et al. Diagnosis and management of acute appendicitis. EAES consensus development conference 2015. Surg Endosc. 2016;30:4668-90.
Dahlberg MJ, Pieniowski EH, Boström LÅ. Trends in the management of acute appendicitis in a single-center quality register cohort of 5,614 patients. Dig Surg. 2018;35:144-54.
Maxfield MW, Schuster KM, Bokhari J, McGillicuddy EA, Davis KA. Predictive factors for failure of nonoperative management in perforated appendicitis. J Trauma Acute Care Surg. 2014;76:976-81.
Markides G, Subar D, Riyad K. Laparoscopic versus open appendectomy in adults with complicated appendicitis: systematic review and meta- analysis. World J Surg. 2010;34:2026-40.
Huston JM, Kao LS, Chang PK, Sanders JM, Buckman S, Adams CA, Cocanour CS, Parli SE, Grabowski J, Diaz J, Tessier JM, Duane TM. Antibiotics vs. Appendectomy for Acute Uncomplicated Appendicitis in Adults: Review of the Evidence and Future Directions. Surg Infect (Larchmt). 2017;18(5) 527-35.
Sartelli M, Baiocchi GL, Di Saverio S, Ferrara F, Labricciosa FM, Ansaloni L, et al. Prospective observational study on acute appendicitis worldwide (POSAW). World J Emerg Surg. 2018;13:19.
Lorenz J, Thomas JL. Complications of percutaneous fluid drainage. Semin Intervent Radiol. 2006;23:194-204.
Jani P, Nyaga P. Peritoneal drains in perforated appendicitis without peritonitis: a prospective randomized controlled study. East Cent Afr J Surg. 2011;16:62-71.
Rather SA, Bari SU, Malik AA, Khan A. Drainage vs no drainage in secondary peritonitis with sepsis following complicated appendicitis in adults in the modern era of antibiotics. World J Gastrointest Surg. 2013;5:300-5.
Gravante G, Overton J, Elshaer M, Sorge R, Kelkar A. Intraperitoneal drains during open appendicectomy for gangrenous and perforated appendicitis. World J Surg Proc. 2013;3;18-24.
Beek MA, Jansen TS, Raats JW, Twiss EL, Gobardhan PD, van Rhede van der Kloot EJ, et al. The utility of peritoneal drains in patients with perforated appendicitis. Springerplus. 2015;4:371.
Petrowsky H, Demartines N, Rousson V, Clavien PA. Evidence-based value of prophylactic drainage in gastrointestinal surgery: a systematic review and meta-analyses. Ann Surg. 2004;240:1074-84.
Li Z, Zhao L, Cheng Y, Cheng N, Deng Y. Abdominal drainage to prevent intra-peritoneal abscess after open appendectomy for complicated appendicitis. Cochrane Database Syst Rev. 2018;5:CD010168.
Cheng Y, Zhou S, Zhou R, Lu J, Wu S, Xiong X, Ye H, Lin Y Wu T, Cheng N. Abdominla drainage to prevent intra-peritoneal abscess after open appendectomy for complicated appendicitis. Cochrane Database Syst Rev. 2015 Feb 7, (2): CD10168.
Abdulhamid AK, Sarker SJ. Is abdominal drainage after open emergency appendectomy for complicated appendicitis beneficial or waste of money? A single centre retrospective cohort study. Ann Med Surg (Lond). 2018;36:168-72.
Horn CB, Coleoglou Centeno AA, Guerra JJ, Mazuski JE, Bochicchio GV1, Turnbull IR. Drain Failure in Intra-Abdominal Abscesses Associated with Appendicitis. Surg Infect (Larchmt). 2018 Apr;19(3):321-5.
Tander B, Pektas O, Bulut M. The utility of peritoneal drains in children with uncomplicated perforated appendicitis. Pediatr Surg Int. 2003;19:548‑50.