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Rosales, Luis; Kcam-Mayorca, Eduardo J; Luna‐Abanto, Jorge; Malpartida-Saavedra, Henry; Flores-Flores, Claudio

doi:10.24875/ciru.19000713

Cited by 9 publications

(13 citation statements)

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“…After reviewing titles/abstracts and excluding duplicates, 1,773 studies were excluded leaving 185 studies. Full manuscripts were reviewed and assessed for eligibility criteria resulting in 17 studies that were included in the analysis [25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41]. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow chart is shown in Figure 3.…”

Section: Resultsmentioning

confidence: 99%

“…The methodological appraisal of the included observational studies [26,29,30,32,33,[34][35][36][37][38][39][40][41] is illustrated in Table 4. The risk of bias was judged as low in two studies [36,39] and moderate in the rest of the observational studies.…”

Section: Methodological Appraisal Of Included Studiesmentioning

confidence: 99%

“…Regarding age group, seven studies had only paediatrics [ 28 - 30 , 33 , 37 , 39 , 41 ]. Three had only adults [ 31 , 38 , 40 ], and the rest had a mixture of both adults and paediatrics population [ 25 - 27 , 32 , 34 - 36 ]. The baseline characteristics were found comparable (Table 3 ).…”

Section: Reviewmentioning

confidence: 99%

“…However, Song and Jung and Pakula et al have found a statistical difference in high-rate intra-abdominal collection and abscess formation in their drain group patients [ 32 , 33 ]. This variation in the rate of intra-abdominal/pelvic collection postoperatively may attribute to many reasons such as too small a drain diameter to drain thick fluids, infection introduced by drain materials or blockage of the drain by a clot or debris [ 38 ].…”

Section: Reviewmentioning

confidence: 99%

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Evaluation of Drain Insertion After Appendicectomy for Complicated Appendicitis: A Systematic Review and Meta-Analysis

Abu¹,

Mohamedahmed²,

Alamin³

et al. 2022

Cureus

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This meta-analysis aims to evaluate the comparative outcomes of drain insertion versus no drain after appendicectomy for complicated appendicitis. A systematic search of PubMed, Cochrane Library and Scopus was conducted, and all studies comparing drain versus no drain after appendicectomy for complicated appendicitis were included. Abdominal collection, surgical site infection (SSI), bowel obstruction, faecal fistula, paralytic ileus, length of hospital stay (LOS) and mortality were the evaluated outcome parameters for the meta-analysis. Seventeen studies reporting a total number of 4,255 patients who underwent appendicectomy for complicated appendicitis with (n=1,580) or without (n=2,657) drain were included. There was no significant difference between the two groups regarding abdominal collection (odds ratio (OR)=1.41, P=0.13). No-drain group was superior to the drain group regarding SSI (OR=1.93, P=0.0001), faecal fistula (OR=4.76, P=0.03), intestinal obstruction (OR=2.40, P=0.04) and paralytic ileus (OR=2.07, P=0.01). There was a difference regarding mortality rate between the two groups (3.4% in the drain group vs 0.5% in the no-drain group, risk difference (RD)=0.01, 95% CI (-0.01, 0.04), P=0.36). In conclusion, this metaanalysis has shown that drains have no effect on the development of intra-abdominal collections in complicated appendicitis, but it can significantly increase the risk of postoperative complications such as fistula, surgical site infection (SSI), bowel obstruction, ileus and length of hospital stay.

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Section: Resultsmentioning

confidence: 99%

Section: Methodological Appraisal Of Included Studiesmentioning

confidence: 99%

Section: Reviewmentioning

confidence: 99%

Section: Reviewmentioning

confidence: 99%

See 2 more Smart Citations

Evaluation of Drain Insertion After Appendicectomy for Complicated Appendicitis: A Systematic Review and Meta-Analysis

Abu¹,

Mohamedahmed²,

Alamin³

et al. 2022

Cureus

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show abstract

“…Complicated appendicitis is defined based on the severity of inflammation as follows: grade II (gangrenous appendix), III (perforated appendix with focal contamination), IV (perforation appendix with abscess formation), and V (perforated appendix with generalized peritonitis). For simplicity, most studies defined the severity of appendicitis by dichotomizing it into simple vs. complicated appendicitis[ 8 – 10 , 15 ] or using descriptive terms such as gangrenous, perforated, or peritonitis [ 6 , 11 ]. One study used the AAST grading system to evaluate the association between abdominal drainage and postoperative IAA after LA [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

The necessity of abdominal drainage for patients with complicated appendicitis undergoing laparoscopic appendectomy: a retrospective cohort study

Liao

Huang

et al. 2022

World J Emerg Surg

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Background This study aimed to evaluate the necessity of abdominal drainage after laparoscopic appendectomy in patients with complicated appendicitis. Methods Patients with acute appendicitis undergoing laparoscopic appendectomy at two hospitals between January 2014 and December 2018 were retrospectively included. Complicated appendicitis was defined as the American Association for the Surgery of Trauma (AAST) grade ≥ II. The patients were classified according to the AAST grade and the indwelling of abdominal drainage. The postoperative surgical outcomes and recovery were compared among patient groups to evaluate the impact of abdominal drainage for patients with complicated appendicitis undergoing laparoscopic appendectomy. Results A total of 1241 patients was retrospectively included. Among them, there were 820 patients with simple appendicitis (AAST grade I) and 421 patients with complicated appendicitis (AAST grade ≥ II). For complicated appendicitis, the drainage group (N = 192) tended to harbor more overall complications, intra-abdominal abscess formation, time to resume a soft diet, and the postoperative length of hospitalization (P = 0.0000 for all). Multivariate logistic regression confirmed that abdominal drainage increased the risk of overall complications [Odds ratio (OR) 2.439; 95% confidence interval (CI) 1.597–3.726; P ≤ 0.0001] and failed to decrease the risk of intra-abdominal abscess formation (OR 1.655; 95% CI 0.487–5.616; P = 0.4193). Multivariate linear regression analysis also showed that the drainage group harbored longer postoperative length of hospitalization (Coefficients: 20.697; 95% CI 15.251–26.143; P < 0.0001) and time to resume a soft diet (Coefficients: 45.899; 95% CI 34.502–57.297; P < 0.0001). Conclusions Abdominal drainage did not prevent overall complications in patients with complicated appendicitis; paradoxically, it delayed the convalescence. Our results discourage the routine use of abdominal drainage and suggest that abdominal drainage should be performed sparingly.

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Abdominal drainage to prevent intra-peritoneal abscess after appendectomy for complicated appendicitis

Zhao

et al. 2021

Cochrane Database of Systematic Reviews

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Cited by 9 publications

References 0 publications

Evaluation of Drain Insertion After Appendicectomy for Complicated Appendicitis: A Systematic Review and Meta-Analysis

Evaluation of Drain Insertion After Appendicectomy for Complicated Appendicitis: A Systematic Review and Meta-Analysis

The necessity of abdominal drainage for patients with complicated appendicitis undergoing laparoscopic appendectomy: a retrospective cohort study

Abdominal drainage to prevent intra-peritoneal abscess after appendectomy for complicated appendicitis

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