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Drain insertion after appendectomy in children with perforated appendicitis based on a single-center experience
1Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.
Annals of Surgical Treatment and Research
|June 2, 2015
Summary
Drain insertion after appendectomy for perforated appendicitis in children did not improve outcomes. This practice was associated with longer hospital stays and increased complication rates, suggesting it should be avoided.
Area of Science:
- Pediatric Surgery
- Surgical Outcomes
- Appendicitis Management
Background:
- Appendicitis management in children lacks consensus.
- Treatment and diagnostic methods vary across institutions.
- The role of peritoneal drains in pediatric appendectomy is debated.
Purpose of the Study:
- To evaluate the effectiveness of peritoneal drain insertion after appendectomy in pediatric patients.
- To determine if drain placement impacts postoperative outcomes in children with perforated appendicitis.
Main Methods:
- Retrospective review of pediatric patients undergoing appendectomy for perforated appendicitis (2003-2012).
- Comparison of patients with and without Jackson-Pratt (JP) drains regarding preoperative factors and postoperative results.
- Statistical analysis using t-tests and chi-square/Fisher exact tests.
Main Results:
- 958 patients reviewed; 342 had perforated appendicitis, with 108 (31.6%) receiving JP drains.
- JP drain group experienced significantly longer hospital stays (6.38 vs. 3.87 days, P < 0.001).
- Higher complication rates (22.2% vs. 6.8%, P = 0.003) were observed in the JP drain group, including intra-abdominal abscesses.
Conclusions:
- Limited evidence supports the routine use of peritoneal drains after appendectomy in children, even for perforated cases.
- Drain insertion was linked to adverse outcomes, including prolonged hospitalization and increased complications.
- Findings suggest reconsidering the use of drains in pediatric appendectomies.
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