Makama J G, Ameh E A, Garba E S
Department of Surgery, Ahmadu Bello University Teaching Hospital, Shika, Zaria.
West Afr J Med. 2015 Jan-Mar;34(1):62-8.
Surgical drains prevent fluid accumulation such as peritoneal fluid, blood, pus or inflammatory exudates. However, complications may occur. The aim of this study is to review the incidence and prevalence of drain site hernia as a complication of surgical drains.
A search of the literature in the MEDLINE database, using PubMed and OvidSP, Scopus, Google Scholar and Cochrane Databases with the following MeSH terms: (Drain or surgical drain or drainage) AND (drain hernia, drain-site hernia, laparoscopic drain-site hernia)was done. Also, these searches done from 14th-31st Dec 2013 were restricted according to the following MeSH limits: (a) January 1, 1980 to December 14, 2013, (b) English articles (c) Human.
Overall, 24 articles had 49 patients with drain site hernias. Of this, 7 (14. 3 %) post open surgery while 42 (85.7 %) post laparoscopic surgery. Seven (14.3 %) occurred immediately after the operation/removal of drain, 10 (20.4 %) several days to 2 week, while 32 (65.3 %) several months to years. Commonest organ of herniation was 13 (26.5 %) small bowel, while morbidities, arising from drain site hernias occurred in 17 (34.7 %) with the highest 7 (14.3 %) due to bowel strangulation. Previous reports have quoted the incidence of drain site hernia to be 3.4% (5 of 148), and 0.14% (8 of 5541). Mortality was extremely low (2.0 %).
Attention is warranted for drain site hernias as a significant complication following placement of surgical drain. Incidence (0.1-3.4 %), though wide range, is quite significant in these patients. Therefore, unwanted surgical drain insertion should be avoided.
手术引流管可防止腹腔积液、血液、脓液或炎性渗出液的积聚。然而，可能会发生并发症。本研究的目的是回顾手术引流管相关并发症——引流管口疝的发病率和患病率。
使用PubMed、OvidSP、Scopus、谷歌学术和Cochrane数据库，在MEDLINE数据库中检索文献，检索词如下：（引流管或手术引流管或引流）以及（引流管疝、引流管口疝、腹腔镜引流管口疝）。此外，2013年12月14日至31日进行的这些检索，根据以下医学主题词限制进行了筛选：（a）1980年1月1日至2013年12月14日，（b）英文文章，（c）人类。
总体而言，24篇文章中有49例患者发生引流管口疝。其中，7例（14.3%）发生于开放手术后，42例（85.7%）发生于腹腔镜手术后。7例（14.3%）在手术/拔除引流管后立即发生，10例（20.4%）在数天至2周后发生，32例（65.3%）在数月至数年后发生。最常见的疝出器官是小肠，共13例（26.5%），而引流管口疝引起的并发症有17例（34.7%），其中因肠绞窄导致的最多，有7例（14.3%）。既往报道的引流管口疝发病率分别为3.4%（148例中有5例）和0.14%（5541例中有8例）。死亡率极低（2.0%）。
手术引流管放置后，引流管口疝作为一种严重并发症值得关注。发病率（0.1% - 3.4%）虽然范围较宽，但在这些患者中相当显著。因此，应避免不必要的手术引流管置入。
