No drains versus drains after perforated peptic ulcer repair: A randomized controlled trail.

Mohammed Elshwadfy Nageeb, Wael Tobar, Ahmed Saqr, Amr Aly Ragab, Ahmed Mohammed Salah Eldeen Othman Elansary

Journal: European journal of trauma and emergency surgery : official publication of the European Trauma Society 2024;50(5):2137-2145

PMID: 38878063

Abstract

PURPOSE

The study aimed to evaluate safety of omitting the intraabdominal drains after perforated peptic ulcer repairs.

MATERIALS AND METHODS

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 ®.

RESULTS

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.

CONCLUSIONS

Omitting the intraabdominal drains is safe after peptic ulcer perforation repair. It can improve outcomes. The study was registered at ClinicalTrials.gov Identifier: NCT06084741.

© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.

Address: Cairo University, Cairo, Egypt. [email protected].; Cairo University, Cairo, Egypt.

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