Drainage or nondrainage in elective colorectal anastomosis: a systematic review and meta-analysis

Drainage or nondrainage in elective colorectal anastomosis: a systematic review and meta-analysis

Autor Karliczek, A. Google Scholar
Jesus, E. C. Google Scholar
Matos, D. Google Scholar
Castro, A. A. Google Scholar
Atallah, A. N. Google Scholar
Wiggers, T. Google Scholar
Instituição Univ Groningen, Univ Med Ctr Groningen
UNIFOA Ctr Univ Volta Redonda
Universidade Federal de São Paulo (UNIFESP)
Resumo Background There is little agreement on prophylactic use of drains in anastomoses in elective colorectal surgery despite many randomized clinical trials. Once anastomotic leakage occurs it is generally agreed that drains Should be used for therapeutic purposes. However, Oil prophylactic use no such agreement exists.Aim To compare the safety and effectiveness of routine drainage and nondrainage regimes after elective colorectal surgery. the primary outcome was clinical anastomotic leakage.Methods A systematic search was undertaken to identify randomized clinical trials. of the 1140 patients who were enrolled (six randomized controlled trials), 573 were allocated for drainage and 567 for no drainage. Outcome measures were: (i) mortality: 3% (18 of 573 patients) compared with 4% (25 of 567 patients); (ii) clinical anastomotic dehiscence: 2% (11 of 522 patients) compared with 1% (7 of 519 patients); (iii) radiological anastomotic dehiscence: 3% (16 of 522 patients) compared with 4% (19 of 519 patients); (iv) wound infection: 5% (29 of 573 patients) compared with 5% (28 of 567 patients); (v) reintervention: 6% (34 of 542 patients) compared with. 5% (28 of 539 patients); (vi) extra-abdominal complications: 7% (34 of 522 patients) compared with 6% (32 of 5 19 patients). None of these differences in outcome was significant.Conclusion There is insufficient evidence showing that routine drainage after colorectal anastomoses prevents anastomotic and other complications.
Palavra-chave drainage
colorectal anastomosis
prophylactic
anastomotic leakage
Idioma Inglês
Data de publicação 2006-05-01
Publicado em Colorectal Disease. Hoboken: Wiley-Blackwell, v. 8, n. 4, p. 259-265, 2006.
ISSN 1462-8910 (Sherpa/Romeo, fator de impacto)
Publicador Wiley-Blackwell
Extensão 259-265
Fonte http://dx.doi.org/10.1111/j.1463-1318.2006.00999.x
Direito de acesso Acesso restrito
Tipo Resenha
Web of Science WOS:000237389300003
Endereço permanente http://repositorio.unifesp.br/handle/11600/28903

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