Kriegmair Maximilian C, Mandel Philipp, Krombach Patrick, Dönmez Hasan, John Axel, Häcker Axel, Michel Maurice S
Department of Urology, University Medical Center Mannheim, Mannheim, Germany.
Department of Urology, University Hamburg-Eppendorf, Hamburg, Germany.
Int J Urol. 2016 May;23(5):390-4. doi: 10.1111/iju.13063. Epub 2016 Feb 18.
To examine the benefit of drain placement during open partial nephrectomy.
Overall, 106 patients treated with open partial nephrectomy were enrolled in a prospective randomized trial. Based on the randomization, a drain was placed or omitted. Complications were assessed according to the Clavien classification. Pain level and requirement for analgesics was evaluated according to a customized pattern.
There was no significant difference in the two groups regarding age, body mass index, American Society of Anesthesiologists score, tumor size and nephrometry (preoperative aspects and dimensions used for an anatomical classification). In terms of overall and drain-related complications, no advantage of placing a drain could be proven (P = 0.249). Patients with a drain suffered from a significantly higher pain level (P = 0.01) and showed prolonged mobilization (P < 0.001). There was no difference in bowel movements and requirement of additional analgesics (P = 0.347 and 0.11).
The results of the study suggest that drain placement during open partial nephrectomy can safely be omitted, even in cases with violation of the collecting system.
探讨开放性部分肾切除术放置引流管的益处。
总共106例行开放性部分肾切除术的患者纳入一项前瞻性随机试验。根据随机分组，一部分患者放置引流管，另一部分不放置。根据Clavien分类法评估并发症。按照定制模式评估疼痛程度和镇痛药物需求。
两组在年龄、体重指数、美国麻醉医师协会评分、肿瘤大小和肾测量（用于解剖学分类的术前情况和尺寸）方面无显著差异。在总体并发症和与引流管相关的并发症方面，未证实放置引流管有任何优势（P = 0.249）。放置引流管的患者疼痛程度显著更高（P = 0.01），且活动恢复时间延长（P < 0.001）。两组在排便情况和额外镇痛药物需求方面无差异（P = 0.347和0.11）。
研究结果表明，即使在集合系统受损的情况下，开放性部分肾切除术也可安全地不放置引流管。
