Journal of Minimally Invasive Surgery 2021; 24(3): 158-164  https://doi.org/10.7602/jmis.2021.24.3.158
Effect of pelvic drain displacement on anastomotic leakage-related morbidity after rectal cancer surgery
Ho Yung Lee, Sung Il Kang, So Hyun Kim, Jae-Hwang Kim
Department of Surgery, Yeungnam University Medical Center, Yeungnam University College of Medicine, Daegu, Korea
Correspondence to: Sung Il Kang
Department of Surgery, Yeungnam University Medical Center, 170 Hyeonchung-ro, Nam-gu, Daegu 42415, Korea
Tel: +82-53-620-3580
Fax: +82-31-787-4055
E-mail: sungiry@naver.com
ORCID:
https://orcid.org/0000-0002-4751-5779
Received: June 30, 2021; Revised: August 28, 2021; Accepted: September 4, 2021; Published online: September 15, 2021.
© The Korean Society of Endoscopic and Laparoscopic Surgeons.

cc This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Purpose: Drain insertion after proctectomy is common in clinical practice, although the effectiveness of drains has been questioned. However, drains are commonly displaced after surgery. We hypothesized that drain displacement is associated with clinical outcomes and aimed to assess differences in clinical outcomes, such as overall morbidity, including anastomotic leakage (AL), reintervention rates, length of hospital stay, and mortality rates, between patients who experienced displaced drains and those who did not.
Methods: Rectal cancer patients who underwent proctectomy at a single institution between January 2015 and December 2020 were retrospectively reviewed. Clinical characteristics were compared between patients who experienced displaced drains and those who did not. The primary endpoint was the occurrence of reintervention in patients with AL. The secondary endpoints were overall morbidity rates, AL rates, length of hospital stay, and mortality within 30 days.
Results: Among 248 patients who underwent proctectomy, 93 (37.5%) experienced displaced drains. A higher proportion of patients who experienced displaced drains required reintervention due to AL than those who did not experience displaced drains (odds ratio, 3.61; 95% confidential interval, 1.20–10.93; p = 0.016). However, no significant difference was found in the overall morbidity rate, mortality, and length of hospital stay between the groups.
Conclusion: Drain displacement does not worsen outcomes such as overall morbidity rate, mortality, and length of hospital stay after proctectomy but is associated with an increase in the need for reintervention in patients with AL.
Keywords: Proctectomy, Drainage, Rectal neoplasms, Anastomotic leak


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