Drainage or nondrainage in elective colorectal anastomosis: a systematic review and meta‐analysis

Karliczek, Anne; Jesus, E. C.; Matos, Délcio; Castro, AA; Atallah, AN; Wiggers, Theo

doi:10.1111/j.1463-1318.2006.00999.x

Cited by 173 publications

(101 citation statements)

References 30 publications

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“…The enteral route for fluid postoperatively should be used as early as possible, and intravenous fluids should be discontinued as soon as is practicable. [148,149]. Subgroup analyses of trials in elective colon resection replicated these findings [149].…”

Section: Summary and Recommendationmentioning

confidence: 83%

Guidelines for Perioperative Care in Elective Colonic Surgery: Enhanced Recovery After Surgery (ERAS^®) Society Recommendations

et al. 2012

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Background This review aims to present a consensus for optimal perioperative care in colonic surgery and to provide graded recommendations for items for an evidencedbased enhanced perioperative protocol. Methods Studies were selected with particular attention paid to meta-analyses, randomised controlled trials and large prospective cohorts. For each item of the perioperative treatment pathway, available English-language literature was examined, reviewed and graded. A consensus recommendation was reached after critical appraisal of the literature by the group. Results For most of the protocol items, recommendations are based on good-quality trials or meta-analyses of goodquality trials (quality of evidence and recommendations according to the GRADE system). Conclusions Based on the evidence available for each item of the multimodal perioperative care pathway, the Enhanced

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Section: Summary and Recommendationmentioning

confidence: 83%

Guidelines for Perioperative Care in Elective Colonic Surgery: Enhanced Recovery After Surgery (ERAS^®) Society Recommendations

et al. 2012

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“…32 Postoperatively, the patient is immediately allowed a diet, and efforts are made to mobilize the patient on postoperative day zero. 33 The Foley catheter is routinely removed by postoperative day 2 or earlier, even if an epidural catheter remains in place. The only exception to this protocol is when the attending physician specifically requests that the Foley catheter remain in place beyond postoperative day 2, typically for cases that involve a low pelvic dissection.…”

Section: Quality Improvement Programsmentioning

confidence: 99%

Improving Outcomes in Colorectal Surgery by Sequential Implementation of Multiple Standardized Care Programs

Keenan

Speicher

Nussbaum

et al. 2015

Journal of the American College of Surgeons

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“…32 Despite this controversy surrounding the necessity to drain, prophylactic drainage remains a common practice in many hospitals, particularly after rectal surgery. 33 In addition, the outcome measures used in these studies consist of leakage rates, hospital stay, radiological anastomotic leakage, infectious complications, and patient comfort. In this study, we have shown diagnostic potential of the drain.…”

Section: Commentsmentioning

confidence: 99%

Acute phase proteins in drain fluid: a new screening tool for colorectal anastomotic leakage? The APPEAL study: analysis of parameters predictive for evident anastomotic leakage

Komen

Slieker

Willemsen

et al. 2014

The American Journal of Surgery

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BACKGROUND: We aim to determine if C-reactive protein (CRP), lipopolysaccharide-binding protein (LBP), and procalcitonin (PCT) in drain fluid can serve as screening tools for colorectal anastomotic leakage (CAL).METHODS: Patients included in this multicenter prospective observational study underwent left hemicolectomy, sigmoid resection, high anterior resection, low anterior resection, or subtotal colectomy. During the first 5 postoperative days, CRP, LBP, and PCT were determined on drain fluid. RESULTS: In total 243 patients were included, of whom 19 (8%) developed CAL. CRP levels were higher in patients with leakage on day 3 and day 5, levels of LBP were higher on days 2, 3, and 4, and PCT levels were higher on day 5. Multivariate analysis showed LBP to be significantly related to CAL. An increase in the average initial value at the first postoperative day with 1 standard deviation increased the risk of leakage by 1.6 times.This research was made possible by grant from ''Stichting Technische Wetenschappen'' (STW), Utrecht, The Netherlands. STW had no role in the study design, in collection, analysis and interpretation of the data, in writing of this manuscript or in the decision to submit.

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Drainage or nondrainage in elective colorectal anastomosis: a systematic review and meta‐analysis

Abstract: There is insufficient evidence showing that routine drainage after colorectal anastomoses prevents anastomotic and other complications.

Cited by 173 publications

References 30 publications

Guidelines for Perioperative Care in Elective Colonic Surgery: Enhanced Recovery After Surgery (ERAS^®) Society Recommendations

Guidelines for Perioperative Care in Elective Colonic Surgery: Enhanced Recovery After Surgery (ERAS^®) Society Recommendations

Improving Outcomes in Colorectal Surgery by Sequential Implementation of Multiple Standardized Care Programs

Acute phase proteins in drain fluid: a new screening tool for colorectal anastomotic leakage? The APPEAL study: analysis of parameters predictive for evident anastomotic leakage

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Drainage or nondrainage in elective colorectal anastomosis: a systematic review and meta‐analysis

Abstract: There is insufficient evidence showing that routine drainage after colorectal anastomoses prevents anastomotic and other complications.

Cited by 173 publications

References 30 publications

Guidelines for Perioperative Care in Elective Colonic Surgery: Enhanced Recovery After Surgery (ERAS®) Society Recommendations

Guidelines for Perioperative Care in Elective Colonic Surgery: Enhanced Recovery After Surgery (ERAS®) Society Recommendations

Improving Outcomes in Colorectal Surgery by Sequential Implementation of Multiple Standardized Care Programs

Acute phase proteins in drain fluid: a new screening tool for colorectal anastomotic leakage? The APPEAL study: analysis of parameters predictive for evident anastomotic leakage

Contact Info

Product

Resources

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Guidelines for Perioperative Care in Elective Colonic Surgery: Enhanced Recovery After Surgery (ERAS^®) Society Recommendations

Guidelines for Perioperative Care in Elective Colonic Surgery: Enhanced Recovery After Surgery (ERAS^®) Society Recommendations