Department of Surgery and Anatomy, Medical School of Ribeirão Preto, University of São Paulo, São Paulo, Brazil.
Surg Obes Relat Dis. 2010 Nov-Dec;6(6):648-52. doi: 10.1016/j.soard.2009.09.017. Epub 2009 Oct 6.
Despite the extensive published data regarding the use of drains in surgery, it is still controversial. Most bariatric surgeons use drains as routinely. However, drains have sometimes have been shown to be unhelpful and even to increase the anastomotic leak rates. The purpose of the present study was to evaluate the peritoneal inflammatory response in the presence of a drain left in place until the seventh postoperative day after bariatric surgery.
All patients who underwent open Roux-en-Y gastric bypass from February 2007 to August 2008 were prospectively evaluated. A 24F Blake drain was left in place for 7 days. The peritoneal effluent from the drain was collected for the determination of cytokine levels and for microbiologic analysis.
A total of 107 obese patients were studied. A marked increase in the levels of tumor necrosis factor-α and interleukin-1β was observed by the seventh postoperative day, even in patients without any abdominal complications. Bacterial contamination of the peritoneal effluent was also demonstrated.
The results of our study have shown that at 7 days after surgery, a marked peritoneal inflammatory response and bacterial contamination are present. These findings could have resulted from the use of the drain for 7 postoperative days.
尽管有关手术中引流管使用的已发表数据广泛，但仍存在争议。大多数减肥外科医生常规使用引流管。然而，引流管有时被证明是无益的，甚至会增加吻合口漏的发生率。本研究的目的是评估在放置引流管至减肥手术后第 7 天的情况下腹膜的炎症反应。
所有 2007 年 2 月至 2008 年 8 月间行开放 Roux-en-Y 胃旁路术的患者均前瞻性评估。留置 24F Blake 引流管 7 天。收集引流管的腹腔渗出液以测定细胞因子水平和进行微生物分析。
共研究了 107 例肥胖患者。术后第 7 天，即使在没有任何腹部并发症的患者中，也观察到肿瘤坏死因子-α和白细胞介素-1β的水平显著增加。腹腔渗出液也存在细菌污染。
我们的研究结果表明，术后第 7 天，存在明显的腹膜炎症反应和细菌污染。这些发现可能是由于引流管放置 7 天所致。
