Use of drainage after laparoscopic complicated appendectomy in children: a single-center experience

Area of Science:

• Pediatric Surgery
• Surgical Complications
• Gastrointestinal Surgery

Background:

• Complicated appendicitis increases postoperative risks in appendectomy patients.
• Abdominal drainage is sometimes used to mitigate these risks.
• The efficacy of abdominal drains in preventing complications post-appendectomy remains unclear.

Purpose of the Study:

• To evaluate the effectiveness of abdominal drains in preventing postoperative complications following appendectomy for complicated appendicitis in pediatric patients.
• To compare outcomes between pediatric patients who received abdominal drains versus those who did not.

Main Methods:

• Retrospective review of pediatric patients undergoing appendectomy for complicated appendicitis at a tertiary center (October 2021 - September 2022).
• Comparison of preoperative characteristics and postoperative outcomes between patients with and without peritoneal drains.
• Analysis included hospital stay duration and time to C-reactive protein (CRP) normalization.

Main Results:

• 44.58% of patients (37/83) received abdominal drains.
• The drain group experienced significantly longer hospital stays (9 vs. 6 days, P=0.0002) and delayed CRP normalization (8 vs. 6 days, P=0.0222).
• While the drain group had a numerically higher complication rate (30.56% vs. 23.81%), this difference was not statistically significant.

Conclusions:

• Abdominal drains did not significantly prevent postoperative complications in pediatric patients with complicated appendicitis undergoing laparoscopic appendectomy.
• Drain placement was associated with extended hospitalization.
• Patients requiring drains may have had more severe underlying conditions, influencing observed outcomes.