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UNICA IRIS Institutional Research Information System
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.
Safety and efficacy of intraperitoneal drain placement after emergency colorectal surgery: An international, prospective cohort study
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D'Amico;S Gili;A Giuliani;G Lisi;B Braccio;V Tiesi;K Stolcers;L Kokaine;V Novikovs;M Farrugia;L Capel;V Bastiaenen;H Heijmans;B Ribeiro da Silva;A Silva;P Botelho;S Henriques;S Z Gan;H Ramanayake;M Nolan;P Kakodkar;H Temperley;P Kakodkar;E Ciofic;A Beuca;B A Pop;M Kurtenkov;M Jovanović;M Vician;P Egea Arias;J Beltrán de Heredia;M Labalde Martinez;I De Santiago Alvarez;M Alvarez-Gallego;E Colás-Ruiz;I Talal El-Abur;J M Rodriguez Artigas;O Dwidar;H K Korkmaz;I C Eray;S Meriç;R Aydin;B Çetin;D Özen;A Yalcinkaya;B E Karaca;O F Kuyumcu;B E Baki;E Yüksel;T K Uprak;M Ugur;K Karabulut;E Kavukçu;A Mansor;R Troller;R Hackett;M Zammit-Maempel;R Sabaratnam;J Nicoletti;A Maan;I Ferarrio;L Dixon;H Halai;S Sethi;L Nelson;A Grassam-Rowe;E Krishnan;D Deeny;M McKeever;A George Pandeth;P Dhavala;S Sreenivasan;G Sundaram Venkatesan;L Zhu;Z Atiyah;J Gregory;T Morey;Z Seymour;L Holdsworth;S Abdelmahmoud;J Bourhill;G Bisheet;J Shaw;K Kulkarni;P Kumarakulasingam;S Pillay;R Al-Habsi;G Kungwengwe;J Richards;K Davoudi;B Ibrahim;B Tailor;M Zayed;F Chen;S Bailey;S Sheefat;G Nawaz;R Pawar;S Marsh;Z H Sam;S Roy Bentley;C Simpson;J Hughes;Y Lim;R Ooi;W H Toh;P Mannion;A Lovett;A Kinčius;S Hussein;E Kirby;R G Beckett;J Salmon;A Rafie;T Glynn;S Y Choo;S Lyons;D Browne;W Ravindran;S Ahmad;M Erotocritou;X Zhu;M Erotocritou;M Bradbury;J McNulty;L McCarthy;J Ng;Z Karmally;K McTeir;M Hanna;E Tan;S Namdeo;R Schembri;E Pusey
2023-01-01
Abstract
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.
drain emergency colorectal surgery postoperative outcomes
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11584/381643
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simulazione ASN
Il report seguente simula gli indicatori relativi alla propria produzione scientifica in relazione alle soglie ASN 2023-2025 del proprio SC/SSD. Si ricorda che il superamento dei valori soglia (almeno 2 su 3) è requisito necessario ma non sufficiente al conseguimento dell'abilitazione. La simulazione si basa sui dati IRIS e sugli indicatori bibliometrici alla data indicata e non tiene conto di eventuali periodi di congedo obbligatorio, che in sede di domanda ASN danno diritto a incrementi percentuali dei valori. La simulazione può differire dall'esito di un’eventuale domanda ASN sia per errori di catalogazione e/o dati mancanti in IRIS, sia per la variabilità dei dati bibliometrici nel tempo. Si consideri che Anvur calcola i valori degli indicatori all'ultima data utile per la presentazione delle domande.
La presente simulazione è stata realizzata sulla base delle specifiche raccolte sul tavolo ER del Focus Group IRIS coordinato dall’Università di Modena e Reggio Emilia e delle regole riportate nel DM 589/2018 e allegata Tabella A. Cineca, l’Università di Modena e Reggio Emilia e il Focus Group IRIS non si assumono alcuna responsabilità in merito all’uso che il diretto interessato o terzi faranno della simulazione. Si specifica inoltre che la simulazione contiene calcoli effettuati con dati e algoritmi di pubblico dominio e deve quindi essere considerata come un mero ausilio al calcolo svolgibile manualmente o con strumenti equivalenti.