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

Surg Innov. 2024 Apr;31(2):157-166. doi: 10.1177/15533506241232598. Epub 2024 Feb 10.

Abstract

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.

Keywords: Crohn’s disease; ileus; prophylactic intraoperative drainage; systemic inflammatory response syndrome.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Ascites* / complications
  • Crohn Disease* / complications
  • Crohn Disease* / surgery
  • Drainage
  • Humans
  • Pilot Projects
  • Postoperative Complications / etiology
  • Postoperative Complications / prevention & control
  • Systemic Inflammatory Response Syndrome / complications