The effect of surgical drainage materials on colonic healing

Smith, S. R. G.; Connolly, J. C.; Crane, Peter; Gilmore, O. J. A.

doi:10.1002/bjs.1800690313

Cited by 56 publications

(20 citation statements)

References 5 publications

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“…Studies in animal models have shown that the use of drains near colonic anastomosis is associated with an increased incidence of anastomotic leakage, morbidity and mortality. 92 Randomised controlled trials have demonstrated no benefit for the use of routine drains for intraperitoneal colonic anastomoses, and their use has largely been abandoned. 93,94 Many surgeons continue to drain rectal anastomoses which lie below the peritoneal reflection within the pelvis, in which haematoma and fluid collections may accumulate.…”

Section: The Role Of Drains To Coloanal and Colorectal Anastomosesmentioning

confidence: 99%

Comparing colorectal cancer treatment and survival for Aboriginal and non‐Aboriginal people in New South Wales

Weir

Supramaniam

Gibberd

et al. 2016

Medical Journal of Australia

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Objectives: Our aim was to compare surgical treatment rates and survival rates for Aboriginal and non‐Aboriginal people in New South Wales with colorectal cancer, and to describe the medical treatment received by a sample of Aboriginal people with colorectal cancer. Design, setting and participants: All people diagnosed with colorectal cancer in NSW during 2001–2007 were identified and their cancer registry records linked to hospital admissions data and death records. A medical records audit of a sample of Aboriginal people diagnosed with colorectal cancer during 2000–2011 was also conducted. Main outcome measures: Cause‐specific survival, odds of surgical treatment, and the proportions of people receiving adjuvant treatments. Results: Of 29 777 eligible colorectal cancer cases, 278 (0.9%) involved Aboriginal people. Similar proportions of Aboriginal (76%) and non‐Aboriginal (79%) people had undergone surgical treatment. Colorectal cancer‐specific survival was similar for Aboriginal and non‐Aboriginal people up to 18 months after diagnosis, but 5 years post‐diagnosis the risk of death for Aboriginal people who had had surgical treatment was 68% higher than for non‐Aboriginal people (adjusted hazards ratio, 1.68; 95% CI, 1.32–2.09). Of 145 Aboriginal people with colorectal cancer identified by the medical records audit, 117 (81%) had undergone surgery, and 56 (48%) had also received adjuvant chemotherapy and/or radiotherapy. Conclusions: Aboriginal people with colorectal cancer had poorer survival rates than non‐Aboriginal people, although rates of surgical treatment, complications and follow‐up colonoscopy were similar. More work is needed to identify and understand why outcomes for Aboriginal people with colorectal cancer are different from those of other New South Wales residents.

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Section: The Role Of Drains To Coloanal and Colorectal Anastomosesmentioning

confidence: 99%

Comparing colorectal cancer treatment and survival for Aboriginal and non‐Aboriginal people in New South Wales

Weir

Supramaniam

Gibberd

et al. 2016

Medical Journal of Australia

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“…An early study found anastomotic breakdown in nearly 50% and extensive adhesion formation in all dogs after placement of latex rubber Penrose drains [24]. A publication on rats reported an increased leakage rate after implantation of latex but not after silicone rubber, polyvinyl chloride, and polytetrafluoroeth-ylene tubes [25]. However, another study with a similar design resulted in decreased resistance of colonic anastomoses with latex drains [26].…”

Section: Discussionmentioning

confidence: 97%

Effects of Intra-Abdominal Drainages on Adhesion Formation and Prevention by Phospholipids in a Rat Model

Bertram¹,

Treutner²,

Tietze³

et al. 2003

Eur Surg Res

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Background and Aims: The study was designed to asses the adhesiogenic capacity of silicone drainages and the protective effect of phospholipids (PL). Materials and Methods: A total of 75 Wistar rats were randomly assigned to the different groups. In a preliminary trial (pt; n = 15), all rats underwent midline laparotomy. The control group (C_pt; n = 5) received no further treatment. In the other animals, either an ‘easy flow’ drainage (EF_pt; n = 5) or an ‘Aachen’ drainage (AC_pt; n = 5) was placed into the abdominal cavity. In the final study (fs; n = 60), rats underwent laparotomy and colonic anastomosis. The control groups (C_fs) received no drainages. In the other groups either one of the two types of drainages (EF_fs, AC_fs) were introduced. In 50% of the rats, 75 mg/kg of PL were administered intraperitoneally (C_fs+PL, EF_fs+PL, AC_fs+PL). The other rats received no additional treatment (C_fsØPL, EF_fsØPL, AC_fsØPL). All animals were sacrificed 10 days after surgery. Areas of adhesions and anastomotic bursting pressures were measured (mean ± SD). Results: In the preliminary trial, analysis of variance (ANOVA) revealed no differences between the groups after application of drainages (values are given in mean ± SD): C_pt mean 23.3 ± 29.4 mm², EF_pt 829.7 ± 679.3 mm², AC_pt 609.9 ± 219.4 mm². In the final study, 2-factorial ANOVA showed a significant effect (p < 0.001) for the use of drainages but not for the application of PL (C_fsØPL 140.6 ± 124.2 mm², C_fs+PL 67.7 ± 60.4 mm², EF_fsØPL 1,217.0 ± 458.3 mm², EF_fs+PL 1,266.8 ± 368.3 mm², AC_fsØPL 861.7 ± 274.8 mm², AC_fs+PL 544.2 ± 193.8 mm²). Post hoc test for pairwise comparisons adjusted to Bonferroni showed significant differences (p < 0.001) between all of the three pairs (C_fs 104.1 ± 92.3 mm² vs. EF_fs 1,241.9 mm² ± 413.3 mm²; C_fs vs. AC_fs 702.9 mm ± 234.3 mm²; EF_fs vs. AC_fs). Discussion: The final study demonstrates the adhesiogenic capacity of silicone drainage tubes in combination with anastomoses. Any protective effect of PL alone or in combination with drainages could not be shown. Conclusions: Indication for the use of drainages in standard surgical procedures should be reconsidered within the scope of their potential to cause adhesions and subsequent complications.

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“…There are surgeons who believe that drainage of peritoneal cavity is impossible, and therefore, prophylactic drainage is useless [15,16]. The surgeons who are opposed to drainage believe that it [17][18][19][20][21][22] (A) Actually stimulates the formation of serous fluid (B) Can lead to infection from outside (C) Increases the rate of leakage by preventing the mobilization of omentum and adjacent organs, obstructing their sealing action on suture line or even creating leakage by mechanical erosion of the anastomoses (D) Is walled off quickly Although there is a considerable theoretical and practical evidences in favor of drainage, the dispute about "to drain or not to drain" the peritoneal cavity after elective colorectal surgery remains open [23]. Anastomotic dehiscence is a serious complication leading to major mortality and morbidity of colorectal surgery [24].…”

Section: Drain Vs No Drainmentioning

confidence: 99%

To Drain or Not to Drain after Colorectal Cancer Surgery

Samaiya¹

2015

Indian J Surg

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Prophylactic drainage of abdominal cavity after GI surgery has been widely practiced. The most important signal function of prophylactic drain is to detect early complications. But the same drains could be the cause of some of the complications. Although there is a considerable theoretical and practical evidences in favor of drainage, the dispute about Bto drain or not to drain^the peritoneal cavity after elective colorectal surgery remains open. Unfortunately, the principle of drainage is not based on any scientific data. During the last three decades, surgeons have made efforts to investigate the value of prophylactic drainage after colorectal surgery. However, the results of trials are contradictory due to lack of quality and/or statistical power and therefore do not provide an answer to the clinical question. A systematic review of studies suggests that there is insufficient evidence for routine use of drain after colorectal surgery. Despite evidence-based data questioning prophylactic drainage of abdominal cavity in many instances, most surgeons around the world continue to use drains on a routine basis until now. There are strong evidences in literature in favor of no apparent benefit of drainage for supra-peritoneal anastomoses; however, there is still controversies regarding drainage of infra-peritoneal rectal anastomoses.

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The effect of surgical drainage materials on colonic healing

Cited by 56 publications

References 5 publications

Comparing colorectal cancer treatment and survival for Aboriginal and non‐Aboriginal people in New South Wales

Comparing colorectal cancer treatment and survival for Aboriginal and non‐Aboriginal people in New South Wales

Effects of Intra-Abdominal Drainages on Adhesion Formation and Prevention by Phospholipids in a Rat Model

To Drain or Not to Drain after Colorectal Cancer Surgery

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