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Randomized trial of pelvic drainage after rectal resection
P M Sagar1, M N Hartley, J Macfie
1Royal Liverpool University Hospital, United Kingdom.
Diseases of the Colon and Rectum
|March 1, 1995
Summary
Routine pelvic drains after rectal resection offer no patient benefit. This study found no reduction in morbidity or mortality, suggesting drains are unnecessary for these procedures.
Area of Science:
- Colorectal Surgery
- Surgical Oncology
- Gastrointestinal Surgery
Background:
- Surgeons often advocate routine pelvic drains after anastomoses.
- Recent evidence suggests limited patient benefit from drainage.
- Drains may introduce morbidity in some patients.
Purpose of the Study:
- To evaluate if high-pressure, closed-suction pelvic drains reduce morbidity.
- To assess the impact of drainage on postoperative fluid collections after rectal resection.
Main Methods:
- 100 patients undergoing rectal resection were randomized: 48 no drain, 52 with a drain for 7 days.
- Groups were similar in age, sex, diagnosis, and anastomosis type.
- Postoperative pelvic ultrasound and contrast studies were performed on day 7.
Main Results:
- No significant difference in morbidity or mortality between drain and no-drain groups.
- Anastomotic leak rates were similar (7/52 drain vs. 2/48 no drain).
- Pelvic fluid collections were more frequent with drains, but not statistically significant.
Conclusions:
- Pelvic drain use after rectal resection provided no discernible patient benefit.
- The routine use of pelvic drains in this setting is not supported by the findings.
- Further research may explore specific indications for pelvic drainage.