Randomized trial of drainage of colorectal anastomosis

Br J Surg. 1993 Jun;80(6):769-71. doi: 10.1002/bjs.1800800640.

Abstract

A prospective randomized trial was carried out to determine whether use of a high-pressure closed-suction intraperitoneal drain was associated with a reduction in morbidity rate after colorectal resection and to examine the influence of drainage on postoperative fluid collections. A consecutive series of 148 patients who underwent colonic or colorectal resection were randomized to receive no drain (n = 51) or a high-pressure closed-suction drain for either 3 (n = 47) or 7 (n = 47) days. Three patients were excluded. All patients underwent abdominal ultrasonography on days 3 and 7 and those undergoing left-sided colorectal resection (n = 96) received a water-soluble contrast enema on day 7. The three groups of patients were similar in age, sex, diagnosis and the numbers of sutured and stapled anastomoses. The presence of a drain did not influence the postoperative morbidity or mortality rate. If the anastomosis leaked, neither faeces nor pus emerged from the drain. Ultrasonographic detection of a fluid collection was of no value: such collections bore no relationship to radiological or clinical leaks or the postoperative course. Routine use of a high-pressure suction drain after colorectal resection appears to be unnecessary.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Anastomosis, Surgical
  • Colon / surgery*
  • Colonic Neoplasms / surgery*
  • Drainage*
  • Female
  • Humans
  • Length of Stay
  • Male
  • Middle Aged
  • Peritoneal Cavity
  • Postoperative Complications
  • Prospective Studies
  • Rectal Neoplasms / surgery*
  • Rectum / surgery*