Time to Avoid Prophylactic Intra-abdominal Drainage in Acute Complicated Appendicitis: An Updated Systematic Review...

This systematic review and meta-analysis sought to compare clinical outcomes between patients who received abdominal drains and those who did not following appendicectomy for complicated appendicitis. A search across MEDLINE, PubMed, ScienceDirect, Embase, Scopus, and ClinicalTrials.gov identified 21 studies with 4,930 patients, including 1,809 with drains and 3,121 without. The meta-analysis revealed no significant statistical difference between the two groups regarding post-operative abdominal collection or mortality. The no-drain group yielded better results, with significantly fewer rates of surgical site infection, faecal fistulae, intestinal obstruction, and paralytic ileus, along with a shorter hospital stay. Additionally, a subgroup analysis of paediatric patients indicated an increased risk of abdominal collection in the drain group. Therefore, the evidence suggests that using an abdominal drain in appendectomy for complicated appendicitis increases post-operative complications, lengthens hospital stays, and elevates the risk of abdominal collection in children.