腹腔镜 Roux-en-Y 胃旁路术治疗病态肥胖术后引流放置对术后疼痛的影响：随机对照试验。

Influence of Drain Placement on Postoperative Pain Following Laparoscopic Roux-en-Y Gastric Bypass for Morbid Obesity: Randomized Controlled Trial.

机构信息

Department of Gastrointestinal Surgery, Inonu University, 44315, Malatya, Turkey.

出版信息

Obes Surg. 2018 Nov;28(11):3499-3504. doi: 10.1007/s11695-018-3374-x.

DOI:10.1007/s11695-018-3374-x

PMID:29971581

Abstract

BACKGROUND

There is currently no evidence to support the routine use of an abdominal drain following laparoscopic Roux-en-Y gastric bypass (RYGB). Our aim was to investigate drain use in laparoscopic RYGB and its effects on postoperative pain.

METHODS

Sixty-six patients were randomly divided into two groups as no-drain (n = 36) and with-drain (n = 30). Intraoperative (time, blood loss, complications) and postoperative outcomes (morbidities, pain scores, hospital stay) were compared.

RESULTS

Demographics of both groups were comparable. Three patients in the no-drain group required a drain (8.3%). Median visual analog scale scores for days 1-3 for with-drain and no-drain groups were 4.5 (2-9) vs. 3 (0-8) (p = 0.02), 3 (0-7) vs. 2 (0-7) (p = 0.10), and 2 (0-7) vs. 0 (0-4) (p = 0.0004), respectively. There was no difference between the groups in terms of complications and length of hospital stay.

CONCLUSION

Drain use increased the postoperative pain following laparoscopic RYGB. Drain placement following laparoscopic RYGB should be selective instead of a routine application.

摘要

背景

目前尚无证据支持腹腔镜 Roux-en-Y 胃旁路术（RYGB）后常规使用腹部引流管。我们的目的是研究腹腔镜 RYGB 中引流管的使用及其对术后疼痛的影响。

方法

将 66 例患者随机分为两组，无引流组（n=36）和有引流组（n=30）。比较两组的术中（时间、出血量、并发症）和术后结果（并发症、疼痛评分、住院时间）。

结果

两组患者的一般资料无差异。无引流组有 3 例（8.3%）需要引流管。有引流组和无引流组术后第 1-3 天的视觉模拟评分中位数分别为 4.5（2-9）vs. 3（0-8）（p=0.02）、3（0-7）vs. 2（0-7）（p=0.10）和 2（0-7）vs. 0（0-4）（p=0.0004）。两组在并发症和住院时间方面无差异。