Prophylactic Intra-abdominal Drainage is Associated With Lower Postoperative Complications in Patients With Crohn's Disease: A Randomized Controlled Trial

被引:0
作者
Duan, Ming [1 ]
Cao, Lei [1 ]
Lu, Mengjie [2 ]
Zhang, Tenghui [1 ]
Ji, Qing [3 ]
Guo, Xian [3 ]
Guo, Zhen [1 ]
Wu, Qiong [4 ]
Liu, Yuxiu [5 ,6 ]
Gong, Jianfeng [1 ]
Zhu, Weiming [1 ]
Li, Yi [1 ,7 ]
机构
[1] Nanjing Univ, Jinling Hosp, Affiliated Hosp Med Sch, Dept Gen Surg, Nanjing, Peoples R China
[2] Shanghai Jiao Tong Univ Sch Med, Sch Publ Hlth, Shanghai, Peoples R China
[3] Jinling Hosp, Affiliated Hosp Med Sch, Dept Anesthesiol, Nanjing, Peoples R China
[4] Jinling Hosp, Affiliated Hosp Med Sch, Dept Sci Res & Training, Nanjing, Peoples R China
[5] Nanjing Med Univ, Jinling Hosp, Dept Crit Care Med, Data & Stat Div, Nanjing, Peoples R China
[6] Southern Med Univ, Sch Publ Hlth, Dept Biostat, Guangzhou, Peoples R China
[7] Nanjing Univ, Jinling Hosp, Affiliated Hosp Med Sch, Dept Gen Surg, 305 East Zhongshan Rd, Nanjing 210002, Jiangsu, Peoples R China
基金
中国国家自然科学基金;
关键词
Crohn's disease; prophylactic intraoperative drainage; ileus; systemic inflammatory response syndrome; EXCLUSIVE ENTERAL NUTRITION; SURGICAL SITE INFECTIONS; ENHANCED RECOVERY; PELVIC DRAINAGE; SURGERY; ANASTOMOSIS; RECURRENCE; GUIDELINES; RESECTION; SOCIETY;
D O I
10.1177/15533506241232598
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background Prophylactic intraoperative drains have been shown not superior for patients underwent intestinal surgery. However, for patients with Crohn's disease (CD), this needs further exploration. Methods In this pilot study, CD patients were randomly assigned to drain (n = 50) and no-drain (n = 50) groups. The primary endpoint was the rate of postoperative prolonged ileus (PPOI). The secondary endpoints were postoperative abdominal ascites, postoperative systemic inflammatory response syndrome (SIRS) and C-reactive protein (CRP) levels. Results The incidences of PPOI and postoperative abdominal ascites were significantly lower in the drain group (12% vs 44%; 0% vs 24%, both P < .05). Postoperative SIRS incidence and CRP levels were significantly increased in the no-drain group [36% vs 10%; 54.9 vs 34.3 mg/L, both P < .05]. In multivariate analysis, prophylactic drainage was the independent protective factor for PPOI and postoperative LOS. Conclusions Prophylactic drainage may be associated with improved clinical outcomes in CD patients.
引用
收藏
页码:157 / 166
页数:10
相关论文
共 41 条
  • [1] Risk factors for surgery and postoperative recurrence in Crohn's disease
    Bernell, O
    Lapidus, A
    Hellers, G
    [J]. ANNALS OF SURGERY, 2000, 231 (01) : 38 - 45
  • [2] Decreasing Risk of First and Subsequent Surgeries in Patients With Crohn's Disease in England From 1994 through 2013
    Burr, Nicholas E.
    Lord, Richard
    Hull, Mark A.
    Subramanian, Venkataraman
    [J]. CLINICAL GASTROENTEROLOGY AND HEPATOLOGY, 2019, 17 (10) : 2042 - +
  • [3] Clinical Practice Guidelines for Enhanced Recovery After Colon and Rectal Surgery From the American Society of Colon and Rectal Surgeons and Society of American Gastrointestinal and Endoscopic Surgeons
    Carmichael, Joseph C.
    Keller, Deborah S.
    Baldini, Gabriele
    Bordeianou, Liliana
    Weiss, Eric
    Lee, Lawrence
    Boutros, Marylise
    McClane, James
    Feldman, Liane S.
    Steele, Scott R.
    [J]. DISEASES OF THE COLON & RECTUM, 2017, 60 (08) : 761 - 784
  • [4] Core outcome set for clinical studies of postoperative ileus after intestinal surgery
    Chapman, S. J.
    Lee, M. J.
    Blackwell, S.
    Arnott, R.
    Ten Broek, R. P. G.
    Delaney, C. P.
    Dudi-Venkata, N. N.
    Fish, R.
    Hind, D.
    Jayne, D. G.
    Mellor, K.
    Mishra, A.
    O'Grady, G.
    Sammour, T.
    Thorpe, G.
    Wells, C., I
    Wolthuis, A. M.
    Fearnhead, N. S.
    Adegbola, S.
    Bagaglini, G.
    Bath, M.
    Bibby, N.
    Bisset, C.
    Blefari, N.
    Blencowe, N. S.
    Bolton, W.
    Bulte, J. P.
    Burch, J.
    Campanelli, M.
    Cano-Valderrama, O.
    Carver, J.
    Challand, C.
    Chan, S.
    Chandler, S.
    Clerc, D.
    Coe, P.
    Cox, D.
    Cross, K. L. R.
    Culkin, A.
    Cuthill, V
    Daniels, S.
    Dawson, A.
    Dawson, L.
    Dixon, F.
    Downey, C.
    Drake, T.
    Duff, S.
    Dunning, G.
    Espin-Basany, E.
    Evans, M. D.
    [J]. BRITISH JOURNAL OF SURGERY, 2022, 109 (06) : 493 - 496
  • [5] Systematic review of definitions and outcome measures for return of bowel function after gastrointestinal surgery
    Chapman, S. J.
    Thorpe, G.
    Vallance, A. E.
    Harji, D. P.
    Lee, M. J.
    Fearnhead, N. S.
    [J]. BJS OPEN, 2019, 3 (01): : 1 - 10
  • [6] A Meta-analysis of Percutaneous Drainage Versus Surgery as the Initial Treatment of Crohn's Disease-related Intra-abdominal Abscess
    Clancy, Cillian
    Boland, Therese
    Deasy, Joseph
    McNamara, Deborah
    Burke, John P.
    [J]. JOURNAL OF CROHNS & COLITIS, 2016, 10 (02) : 202 - 208
  • [7] The Clavien-Dindo Classification of Surgical Complications Five-Year Experience
    Clavien, Pierre A.
    Barkun, Jeffrey
    de Oliveira, Michelle L.
    Vauthey, Jean Nicolas
    Dindo, Daniel
    Schulick, Richard D.
    de Santibanes, Eduardo
    Pekolj, Juan
    Slankamenac, Ksenija
    Bassi, Claudio
    Graf, Rolf
    Vonlanthen, Rene
    Padbury, Robert
    Cameron, John L.
    Makuuchi, Masatoshi
    [J]. ANNALS OF SURGERY, 2009, 250 (02) : 187 - 196
  • [8] A Reappraisal of Outcome of Elective Surgery After Successful Non-Operative Management of an Intra-Abdominal Abscess Complicating Ileocolonic Crohn's Disease: A Subgroup Analysis of a Nationwide Prospective Cohort
    Collard, M. K.
    Benoist, S.
    Maggiori, L.
    Zerbib, P.
    Lefevre, J. H.
    Denost, Q.
    Germain, A.
    Cotte, E.
    Beyer-Berjot, L.
    Corte, H.
    Desfourneaux, V
    Rahili, A.
    Duffas, J. P.
    Pautrat, K.
    Denet, C.
    Bridoux, V
    Meurette, G.
    Faucheron, J. L.
    Loriau, J.
    Souche, R.
    Vicaut, E.
    Panis, Y.
    Brouquet, A.
    [J]. JOURNAL OF CROHNS & COLITIS, 2021, 15 (03) : 409 - 418
  • [9] Increased incidence of prolonged ileus after colectomy for inflammatory bowel diseases under ERAS protocol: a cohort analysis
    Dai, Xujie
    Ge, Xiaolong
    Yang, Jianbo
    Zhang, Tenghui
    Xie, Tingbin
    Gao, Wen
    Gong, Jianfeng
    Zhu, Weiming
    [J]. JOURNAL OF SURGICAL RESEARCH, 2017, 212 : 86 - 93
  • [10] 3rd European Evidence-based Consensus on the Diagnosis and Management of Crohn's Disease 2016: Part 1: Diagnosis and Medical Management
    Gomollon, Fernando
    Dignass, Axel
    Annese, Vito
    Tilg, Herbert
    Van Assche, Gert
    Lindsay, James O.
    Peyrin-Biroulet, Laurent
    Cullen, Garret J.
    Daperno, Marco
    Kucharzik, Torsten
    Rieder, Florian
    Almer, Sven o
    Armuzzi, Alessandro
    Harbord, Marcus
    Langhorst, Jost
    Sans, Miquel
    Chowers, Yehuda
    Fiorino, Gionata
    Juillerat, Pascal
    Mantzaris, Gerassimos J.
    Rizzello, Fernando
    Vavricka, Stephan
    Gionchetti, Paolo
    [J]. JOURNAL OF CROHNS & COLITIS, 2017, 11 (01) : 3 - 25