TY - JOUR
T1 - Safety and efficacy of intraperitoneal drain placement after emergency colorectal surgery
T2 - An international, prospective cohort study
AU - EuroSurg Collaborative
AU - Sgrò, A.
AU - Blanco-Colino, R.
AU - Ahmed, W. U. R.
AU - Brindl, N.
AU - Gujjuri, R. R.
AU - Lapolla, P.
AU - Mills, E. C.
AU - Pérez-Ajates, S.
AU - Soares, A. S.
AU - Varghese, C.
AU - Xu, W.
AU - McLean, K. A.
AU - Chapman, S. J.
AU - Espín-Basany, E.
AU - Glasbey, J. C.
AU - Mihaljevic, A.
AU - Nepogodiev, D.
AU - Pata, F.
AU - Pellino, G.
AU - Pockney, P.
AU - Dudi-Venkata, N. N.
AU - Egoroff, N.
AU - Ludbrook, I.
AU - Raubenheimer, K.
AU - Richards, T.
AU - Pockney, P.
AU - Delibegovic, S.
AU - Salibasic, M.
AU - Amjad, T.
AU - Brindl, N.
AU - Dörr-Harim, C.
AU - Gedeon, N.
AU - Gsenger, J.
AU - Mihaljevic, A.
AU - Tachezy, M.
AU - Bini, S.
AU - Gallo, G.
AU - Gori, A.
AU - Lapolla, P.
AU - Pata, F.
AU - Pellino, G.
AU - Wang, J.
AU - Meima - van Praag, E. M.
AU - Tanis, P.
AU - Tanis, P.
AU - Chen, J.
AU - Detering, R.
AU - Zhang, Y.
AU - Bastiaenen, V.
AU - Zhu, L.
N1 - Funding Information: The protocol for the COMPASS project was pre-published; however, this study was not pre-registered at an institutional registry. The authors are grateful to the European Society of Coloproctology (ESCP) Executive for providing facilities to host collaborator meetings in Vienna (September 2019); and to the Student Audit and Research in Surgery (STARSurg) collaborative, the Portuguese Surgical Research Collaborative (PTSurg), the Italian Surgical Research Group (ItSurg), the Student-Initiated German Medical Audit (SIGMA) collaborative and the Trials and Audit in Surgery by Medical Students in Australia and New Zealand (TASMAN) collaborative for assistance with study dissemination. They thank the Birmingham Surgical Trials Consortium at the University of Birmingham (UK) for support with online data capture. Publisher Copyright: © 2023 Association of Coloproctology of Great Britain and Ireland.
PY - 2023/10/1
Y1 - 2023/10/1
N2 - Aim: Intraperitoneal drains are often placed during emergency colorectal surgery. However, there is a lack of evidence supporting their use. This study aimed to describe the efficacy and safety of intraperitoneal drain placement after emergency colorectal surgery. Method: COMPlicAted intra-abdominal collectionS after colorectal Surgery (COMPASS) is a prospective, international, cohort study into which consecutive adult patients undergoing emergency colorectal surgery were enrolled (from 3 February 2020 to 8 March 2020). The primary outcome was the rate of intraperitoneal drain placement. Secondary outcomes included rate and time-to-diagnosis of postoperative intraperitoneal collections, rate of surgical site infections (SSIs), time to discharge and 30-day major postoperative complications (Clavien–Dindo III–V). Multivariable logistic and Cox proportional hazards regressions were used to estimate the independent association of the outcomes with drain placement. Results: Some 725 patients (median age 68.0 years; 349 [48.1%] women) from 22 countries were included. The drain insertion rate was 53.7% (389 patients). Following multivariable adjustment, drains were not significantly associated with reduced rates (odds ratio [OR] = 1.56, 95% CI: 0.48–5.02, p = 0.457) or earlier detection (hazard ratio [HR] = 1.07, 95% CI: 0.61–1.90, p = 0.805) of collections. Drains were not significantly associated with worse major postoperative complications (OR = 1.26, 95% CI: 0.67–2.36, p = 0.478), delayed hospital discharge (HR = 1.11, 95% CI: 0.91–1.36, p = 0.303) or increased risk of SSIs (OR = 1.61, 95% CI: 0.87–2.99, p = 0.128). Conclusion: This is the first study investigating placement of intraperitoneal drains following emergency colorectal surgery. The safety and clinical benefit of drains remain uncertain. Equipoise exists for randomized trials to define the safety and efficacy of drains in emergency colorectal surgery.
AB - Aim: Intraperitoneal drains are often placed during emergency colorectal surgery. However, there is a lack of evidence supporting their use. This study aimed to describe the efficacy and safety of intraperitoneal drain placement after emergency colorectal surgery. Method: COMPlicAted intra-abdominal collectionS after colorectal Surgery (COMPASS) is a prospective, international, cohort study into which consecutive adult patients undergoing emergency colorectal surgery were enrolled (from 3 February 2020 to 8 March 2020). The primary outcome was the rate of intraperitoneal drain placement. Secondary outcomes included rate and time-to-diagnosis of postoperative intraperitoneal collections, rate of surgical site infections (SSIs), time to discharge and 30-day major postoperative complications (Clavien–Dindo III–V). Multivariable logistic and Cox proportional hazards regressions were used to estimate the independent association of the outcomes with drain placement. Results: Some 725 patients (median age 68.0 years; 349 [48.1%] women) from 22 countries were included. The drain insertion rate was 53.7% (389 patients). Following multivariable adjustment, drains were not significantly associated with reduced rates (odds ratio [OR] = 1.56, 95% CI: 0.48–5.02, p = 0.457) or earlier detection (hazard ratio [HR] = 1.07, 95% CI: 0.61–1.90, p = 0.805) of collections. Drains were not significantly associated with worse major postoperative complications (OR = 1.26, 95% CI: 0.67–2.36, p = 0.478), delayed hospital discharge (HR = 1.11, 95% CI: 0.91–1.36, p = 0.303) or increased risk of SSIs (OR = 1.61, 95% CI: 0.87–2.99, p = 0.128). Conclusion: This is the first study investigating placement of intraperitoneal drains following emergency colorectal surgery. The safety and clinical benefit of drains remain uncertain. Equipoise exists for randomized trials to define the safety and efficacy of drains in emergency colorectal surgery.
KW - drain
KW - emergency colorectal surgery
KW - postoperative outcomes
UR - http://www.scopus.com/inward/record.url?scp=85175741650&partnerID=8YFLogxK
U2 - https://doi.org/10.1111/codi.16737
DO - https://doi.org/10.1111/codi.16737
M3 - Article
C2 - 37700554
SN - 1462-8910
VL - 25
SP - 2043
EP - 2053
JO - Colorectal disease
JF - Colorectal disease
IS - 10
ER -