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International Journal of Colorectal Disease

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Open Access 01-05-2016 | Review

To drain or not to drain in colorectal anastomosis: a meta-analysis

Authors: Hong-Yu Zhang, Chun-Lin Zhao, Jing Xie, Yan-Wei Ye, Jun-Feng Sun, Zhao-Hui Ding, Hua-Nan Xu, Li Ding

Published in: International Journal of Colorectal Disease | Issue 5/2016

Abstract

Background

Currently, many surgeons place a prophylactic drain in the abdominal or pelvic cavity after colorectal anastomosis as a conventional treatment. However, some trials have demonstrated that this procedure may not be beneficial to the patients.

Objective

To determine whether prophylactic placement of a drain in colorectal anastomosis can reduce postoperative complications.

Methods

We systematically searched all the electronic databases for randomized controlled trials (RCTs) that compared routine use of drainage to non-drainage regimes after colorectal anastomosis, using the terms “colorectal” or “colon/colonic” or “rectum/rectal” and “anastomo*” and “drain or drainage.” Reference lists of relevant articles, conference proceedings, and ongoing trial databases were also screened. Primary outcome measures were clinical and radiological anastomotic leakage. Secondary outcome measures included mortality, wound infection, re-operation, and respiratory complications. We assessed the eligible studies for risk of bias using the Cochrane Risk of Bias Tool. Two authors independently extracted data.

Results

Eleven RCTs were included (1803 patients in total, 939 patients in the drain group and 864 patients in the no drain group). Meta-analysis showed that there was no statistically significant differences between the drain group and the no drain group in (1) overall anastomotic leakage (relative risk (RR) = 1.14, 95 % confidence interval (CI) 0.80–1.62, P = 0.47), (2) clinical anastomotic leakage (RR = 1.39, 95 % CI 0.80–2.39, P = 0.24), (3) radiologic anastomotic leakage (RR = 0.92, 95 % CI 0.56–1.51, P = 0.74), (4) mortality (RR = 0.94, 95 % CI 0.57–1.55, P = 0.81), (5) wound infection (RR = 1.19, 95 % CI 0.84–1.69, P = 0.34), (6) re-operation (RR = 1.18, 95 % CI 0.75–1.85, P = 0.47), and (7) respiratory complications (RR = 0.82, 95 % CI 0.55–1.23, P = 0.34).

Conclusions

Routine use of prophylactic drainage in colorectal anastomosis does not benefit in decreasing postoperative complications.

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Title: To drain or not to drain in colorectal anastomosis: a meta-analysis
Authors: Hong-Yu Zhang
Chun-Lin Zhao
Jing Xie
Yan-Wei Ye
Jun-Feng Sun
Zhao-Hui Ding
Hua-Nan Xu
Li Ding
Publication date: 01-05-2016
Publisher: Springer Berlin Heidelberg
Published in: International Journal of Colorectal Disease / Issue 5/2016
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-016-2509-6

At a glance: The STEP trials

Springer Medicine

To drain or not to drain in colorectal anastomosis: a meta-analysis

Abstract

Background

Objective

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Objective

Methods

Results

Conclusions

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