Cairo University, Cairo, Egypt.
Eur J Trauma Emerg Surg. 2024 Oct;50(5):2137-2145. doi: 10.1007/s00068-024-02551-6. Epub 2024 Jun 15.
The study aimed to evaluate safety of omitting the intraabdominal drains after perforated peptic ulcer repairs.
We conducted a prospective, randomized, controlled trial from January 2022 to January 2024 at the Emergency surgery department. Patients with perforated peptic ulcers were evaluated for eligibility. They were randomly assigned into two groups. In group A: two intraabdominal drains (pelvic and hepatorenal). in group B: no intraabdominal drains. The primary outcome was hospital length of stay (LOS), and the secondary outcomes included parameters of recovery and 30-day morbidities. The data were analyzed using SPSS 16 ®.
Thirty five patients were in the no drain group, while 36 patients were in the drain group. Patients in the no drains group had significantly earlier bowel motion (21.6 vs 28.69 hours; p = 0.004), fluid diet (73.54 vs 86.78 hours; p 0.001), and solid intake (84.4 vs. 98 hours; p 0.001), less pain severity (p = 0.0001) and shorter hospital stay (4.74 vs 5.75 days; p 0.001). A significant less morbidity, including surgical site infection (p = 0.01), and respiratory complications (p 0.0001), were in the no drain group. There was no difference of fever duration nor wound dehiscence.
Omitting the intraabdominal drains is safe after peptic ulcer perforation repair. It can improve outcomes. The study was registered at ClinicalTrials.gov Identifier: NCT06084741.
本研究旨在评估在胃十二指肠穿孔修补术后是否可以安全地不放置腹腔引流管。
我们于 2022 年 1 月至 2024 年 1 月在急诊外科进行了一项前瞻性、随机、对照试验。对胃十二指肠穿孔患者进行评估以确定其是否符合入选标准。患者被随机分为两组。A 组:两个腹腔引流管(盆腔和肝肾间隙)。B 组:无腹腔引流管。主要结局是住院时间(LOS),次要结局包括恢复参数和 30 天内的并发症。数据使用 SPSS 16 ® 进行分析。
无引流组 35 例,引流组 36 例。无引流组患者的肠功能恢复更快(21.6 与 28.69 小时;p=0.004)、开始进液量饮食更早(73.54 与 86.78 小时;p<0.001)、开始进固体饮食更早(84.4 与 98 小时;p<0.001)、疼痛程度更轻(p=0.0001)、住院时间更短(4.74 与 5.75 天;p<0.001)。无引流组的并发症发生率显著较低,包括手术部位感染(p=0.01)和呼吸并发症(p<0.0001)。两组发热持续时间和伤口裂开率无差异。
在胃十二指肠溃疡穿孔修补术后不放置腹腔引流管是安全的,可以改善预后。该研究已在 ClinicalTrials.gov 注册,编号为 NCT06084741。