Open AccessIntraperitoneal drain placement and outcomes after elective colorectal surgery: international matched, prospective, cohort study
Author(s) -
A Sgrò,
Ruth BlancoColino,
WUR Ahmed,
Niall Brindl,
RR Gujjuri,
Pierfrancesco Lapolla,
EC Mills,
S Pérez-Ajates,
AS Soares,
Chris Varghese,
William Xu,
Kenneth A McLean,
SJ Chapman,
Eloy Espín,
James Glasbey,
André L. Mihaljević,
Dmitri Nepogodiev,
Francesco Pata,
Gianluca Pellino,
Peter Pockney,
Nagendra N. DudiVenkata,
N Egoroff,
Isabella Ludbrook,
Kyle Raubenheimer,
Toby Richards,
S Delibegovic,
Mirhan Salibasic,
T Amjad,
Colette Dörr-Harim,
Naomi Gedeon,
Julia Gsenger,
Michael Tachezy,
Simone Bini,
Gaetano Gallo,
Gregorio Tugnoli,
Arcangelo Picciariello,
Mauro Podda,
Cristiana Riboni,
MJ Machatschek,
Anh Nguyen,
Matas Jakubauskas,
Marius Kryžauskas,
Tomas Poškus,
SZ Kuiper,
Jin Wang,
CI Wells,
IP Bissett,
KM Augestad,
Ingeborg Haug Steinholt,
BN Vieira,
Jovan Juloski,
O Anabitarte Bautista,
Y El Kasmy El Kasmy,
Paula Martín-Borregón,
Marián Revilla,
Stephanie Van Straten,
MK Aktas,
BE Baki,
Melika Akhbari,
Daniel Baker,
Sanchita Bhatia,
Steven R. Brown,
William Cambridge,
Sivesh K. Kamarajah,
RA Khaw,
Omar Kouli,
Victoria Murray,
Isobel M Trout,
Ifat Yasin,
Y. J.,
H Reyhani,
KHF Wong,
R Pancharatnam,
WL Chia,
A. D. Walmsley,
A Hassane,
D Saeed,
B Wang,
B Walters,
Z Nowinka,
Abdulaziz Alsaif,
Mehdi Ali Mirza,
Katharine Foster,
J. Luu,
Pramath Kakodkar,
JT Hughes,
Thinesshwary Yogarajah,
A Antypas,
Atiqur Rahman,
Melissa Bradbury,
Michael McLar,
Sana Ehsen Nagi,
AM Riad,
M Erotocritou,
Harry Kyriacou,
Viktorija Kaminskaite,
S Alfadhel,
Q Fatimah Hussain,
Anjali Handa,
C Massy-Westropp,
Svemir Čustović,
Rosen Dimov,
Hira Mughal,
Mihail Slavchev,
Tsvetomir Ivanov,
Nikolaos Gouvas,
Aseel Hegazi,
Petr Kocián,
MD Kjaer,
Anders MarkChristensen,
Dimitrios Papakonstantinou,
Nikolaos Machairas,
Tania Triantafyllou,
Zoe Garoufalia,
Dimitrios Korkolis,
Antonio Castaldi,
S Giaccari,
Gaya Spolverato,
G Pagano,
Marco Milone,
Giulia Turri,
F. Colombo,
Eugenio Cucinotta,
Gaetano Poillucci,
Teresa Perra,
Roberta Tutino,
Francesco Belia,
Diego Coletta,
Antonio Belli,
Daniela Rega,
Pasquale Cianci,
Giovanni Pirozzolo,
M. Di Lena,
Fabrizio Perrone,
Alessandro Giani,
Federico Lovisetto,
M Grassia,
NS Pipitone Federico,
Francesco Ferrara,
Alessia Biancafarina,
Nicolò Tamini,
Giovanni Sinibaldi,
F Tuminello,
Raffaele Galleano,
Diego Sasia,
L Bragaglia,
A De Manzoni Garberini,
Antonio Pesce,
F Cassaro,
Paolina Venturelli,
Gian Luigi Canu,
G Esposito,
Michela Campanelli,
Roberto Cardia,
Marco Ricciardiello,
Andrea Sagnotta,
Giuseppe Caico,
G. De Marco,
Antonio Cappiello,
Enrico Pinotti,
Francesco Carlei,
Giorgio Lisi,
Giulia Bagaglini,
M Farrugia,
E Meima - van Praag,
Cristina Monteiro,
Mário Pereira,
Pedro Botelho,
A Quigley,
A O’Neill,
L Gaule,
Lauren Crone,
Amber Arnold,
Florin Grama,
A Beuca,
Inna Tulina,
Andrey Litvin,
Arpád Panyko,
M. E. Ossola,
J Trujillo Díaz,
JM Marín Santos,
Ester Alonso Batanero,
Sara Gortázar de las Casas,
C Soldevila Verdeguer,
Enrique ColásRuiz,
I Talal El-Abur,
Melody García Domínguez,
M Delorme,
MarcOlivier Sauvain,
Berk B. Özmen,
BB Ozkan,
F Calikoglu,
Said Kural,
F Zafer,
Yunus Kaya,
Ali Yalçınkaya,
K Kargici,
Mustafa Deniz Tepe,
OC Tatar,
E Kabadayi,
A Yıldırım,
D Hurmuzlu,
Kemal Korkmaz,
Pradeep Sharma,
R Troller,
N Hagan,
J Mooney,
Alexander Light,
Michael Tansey,
Deepika Bhojwani,
RM McGing,
A Mallon,
Marc Fadel,
C Spilsbury,
Rodney James,
Stephen O’Brien,
Amanda Isaac,
S. Balasubramanya,
Hatem Sadik,
Tanzeela Gala,
Jy Chen,
Benjamin Turner,
En Lin Goh,
Karim Hassan,
Mehrdad Bakhshayesh Karam,
P Mason,
Nikolaos Tzoumas,
T Noton,
JK Seehra,
Nauman Ahmed,
R Motiwale,
Vasantkumar L. Tanna,
Andreas A. Argyriou,
SK Bylapudi,
N Grace,
Sehrish Latif,
Adam Hounat,
JS Kiam,
Masooma Zaidi,
K Elsamani,
Christopher Hughes,
Amritha Suresh,
LOH Sinan,
D El-Dalil,
EJM Khoo,
EE Salim,
Dan Stark,
N Minhas,
G Fowler,
E. Douglas Rees,
I Giudiceandrea,
A Bardon,
P Jayawardena,
N Dieseru,
Andrew J. Murphy,
Charlotte Yates,
Karolina Ziółkowska,
A Rafie,
F Khoda,
Michael Okocha,
Thomas Ashdown,
Parveen VitishSharma,
J Gilliland,
Simon Toh,
K. A. Jones,
A Devine,
Alexander Berry,
Shan K. McDonnell,
James Olivier,
Gillian Richardson,
Lim Hj,
N. Slim,
K Elsayeh,
Tarik Sammour,
Alexandar Sarpanov,
Nikolay Belev,
Dobromir Dimitrov,
Tina Dušek,
Vasileia Ntomi,
G.C. Sotiropoulos,
Dimitrios Theodorou,
Nikolaos Nikiteas,
Dimitrios Balalis,
Carmine Antropoli,
DF Altomare,
Gaetano Luglio,
Giovanni Domenico De Palma,
Corrado Pedrazzani,
L Simonelli,
Stefania Brozzetti,
Alberto Porcu,
Marco Massani,
Gian Luca Grazi,
Francesco Izzo,
Paolo Delrio,
Enrico Restini,
G Chetta,
G Lantone,
Guglielmo Ferrari,
Andrea Lucchi,
Marco De Prizio,
G. Caristo,
Felice Borghi,
Niccolò Petrucciani,
Cristiano Huscher,
Gianfranco Cocorullo,
Valeria Tonini,
Fabio Medas,
Giuseppe Sica,
Nicola Cillara,
Alessandro Anastasi,
Francesco Bianco,
Antonio Giuliani,
Massimo Carlini,
Francesco Selvaggi,
G Sammarco,
Artūrs Ozoliņš,
Aleksandrs Malasonoks,
Predrag Andrejevic,
Pieter J. Tanis,
Andrew Van de Ven,
Michael F. Gerhards,
Bruno Ribeiro da Silva,
A Silva,
MJ Lima,
Dara O. Kavanagh,
N McCawley,
Vasile Bințințan,
Aleksandar Karamarković,
G Sanz Ortega,
Beatriz De Andrés-Asenjo,
Cristievado García,
Luis Flórez,
Juan José SeguraSampedro,
JL Blas Laina,
Luca Ponchietti,
Pamela Buchwald,
Eleftherios Gialamas,
Volkan Özben,
Ahmet Rencüzoğulları,
İE Gecim,
Yüksel Altinel,
Özgen Işık,
T Yoldas,
Arda Işık,
Sezai Leventoğlu,
Şükrü Mehmet Ertürk,
Ali Güner,
SA Güler,
Wafi Attaallah,
Murat Uğur,
GS Özbalcı,
Himaz Marzook,
N Eardley,
Sebastian Smolarek,
Rebecca Morgan,
C Roxburgh,
AK Lala,
Y Salama,
Baljit Singh,
A Khanna,
Mary Evans,
Irshad Shaikh,
K Thippeswamy,
Budd Appleton,
Susan Moug,
Ian Smith,
Neil Smart,
Pallav L. Shah,
G. Williams,
G Khera,
A Goede,
M Varcada,
Chetan Parmar,
Sarah Duff,
Rachel Hargest,
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Bethany Furfaro,
Davina Daudu,
N Golijanin,
WY Yek,
Giovanni Moggio Lorenzo Capasso,
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iu,
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Ajna Hamidovic,
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Emina Letić,
Amina Aljić,
M Helez,
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P Kavradjieva,
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Paulina Vladova,
Sergey Iliev,
Tsanko Yotsov,
Η Ευσταθίου,
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Rabiya Altaf,
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Georgia Bompetsi,
Theodoros Sidiropoulos,
Paraskevas Stamopoulos,
Charalampos Theodoropoulos,
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Theodora Palyvou,
Alexandros Charalabopoulos,
Athanasios Syllaios,
Dimitriοs Schizas,
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Ilias Vagios,
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Spyridon Davakis,
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Andrea Urbani,
Elizabeth J. Rossin,
Giulia Nezi,
Piero Romano,
Alfonso Amendola,
Elisa Espósito,
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Sara Vertaldi,
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ZS Sabrina,
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Maria Carmela Piccirillo,
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Martin Dubovský,
Martina Hrošová,
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Marta Roldón Golet,
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Minoru Aba,
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YM Akkaya,
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MA Usta,
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SueAnn Meehan,
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Michael X. Fu,
Michal Kawka,
Tamara Ali,
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C Thomas,
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Joan T. Moroney,
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Alex Boulter,
J Kayran,
Mainak Banerjee,
N Parekh-Hill,
Amanda J. Hooper,
Joel Bowen,
Rakesh Kumar Jagdish,
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Panche Krastev,
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Jan Votava,
for the Saskatchewan Farm Injury St,
Νικόλαος Κολιάκος,
Petros Tsaparas,
George C. Zografos,
Dimitrios Mantas,
Gerasimos Tsourouflis,
Εvangelos C. Fradelos,
Giuseppe Trigiante,
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Jeremy Hughes,
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Phillip D Mannion,
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Arnold Kincius,
Safaa Abd Elsalam Hussein,
Emma Kirby,
RG Beckett,
J Salmon,
T. Glynn,
SY Choo,
S Lyons,
Deirdre Browne,
W Ravindran,
Shabir Ahmad,
Xi Zhu,
Jennifer E. McNulty,
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Publication year - 2022
Publication title -
british journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.202
H-Index - 201
eISSN - 1365-2168
pISSN - 0007-1323
DOI - 10.1093/bjs/znac069
Subject(s) - medicine , hazard ratio , odds ratio , prospective cohort study , surgery , colorectal surgery , propensity score matching , logistic regression , proportional hazards model , cohort , cohort study , confidence interval , abdominal surgery
Background Many surgeons routinely place intraperitoneal drains after elective colorectal surgery. However, enhanced recovery after surgery guidelines recommend against their routine use owing to a lack of clear clinical benefit. This study aimed to describe international variation in intraperitoneal drain placement and the safety of this practice. Methods COMPASS (COMPlicAted intra-abdominal collectionS after colorectal Surgery) was a prospective, international, cohort study which enrolled consecutive adults undergoing elective colorectal surgery (February to March 2020). The primary outcome was the rate of intraperitoneal drain placement. Secondary outcomes included: rate and time to diagnosis of postoperative intraperitoneal collections; rate of surgical site infections (SSIs); time to discharge; and 30-day major postoperative complications (Clavien–Dindo grade at least III). After propensity score matching, multivariable logistic regression and Cox proportional hazards regression were used to estimate the independent association of the secondary outcomes with drain placement. Results Overall, 1805 patients from 22 countries were included (798 women, 44.2 per cent; median age 67.0 years). The drain insertion rate was 51.9 per cent (937 patients). After matching, drains were not associated with reduced rates (odds ratio (OR) 1.33, 95 per cent c.i. 0.79 to 2.23; P = 0.287) or earlier detection (hazard ratio (HR) 0.87, 0.33 to 2.31; P = 0.780) of collections. Although not associated with worse major postoperative complications (OR 1.09, 0.68 to 1.75; P = 0.709), drains were associated with delayed hospital discharge (HR 0.58, 0.52 to 0.66; P < 0.001) and an increased risk of SSIs (OR 2.47, 1.50 to 4.05; P < 0.001). Conclusion Intraperitoneal drain placement after elective colorectal surgery is not associated with earlier detection of postoperative collections, but prolongs hospital stay and increases SSI risk.
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