Does drainage of the peritoneal cavity have an impact on the postoperative course of community-acquired, secondary, lower gastrointestinal tract peritonitis?
Résumé
BACKGROUND: In the surgical management of lower gastrointestinal tract peritonitis (LGTP), drainage of the peritoneal cavity is often recommended. The objective of the study was to evaluate the impact of drainage of the abdominal cavity during management of LGTP. METHODS: From January 2009 to January 2012, patients undergoing surgery for LGTP were included. The study comprised 3 steps: (1) description of the overall population; (2) comparison of the ``no drainage'' and ``drainage'' groups; and (3) a propensity score-matched analysis. The primary end point was the major complications rate; secondary end points were the overall complication, risk factors for postoperative complications, and the length of hospital stay. RESULTS: A total of 205 patients underwent surgery for LGTP. Characteristics of the peritoneum were noted on the surgical report in 141 cases (68%). Abdominal drainage was implemented in 118 patients (83%). After propensity score matching, there was no difference between drainage and no drainage groups in the major postoperative complications (34.7% vs 34.8%; P = .89). CONCLUSIONS: Drainage of the abdominal cavity had no impact on postoperative abscess and reoperation rates. Standardization of drainage in this context is required. (C) 2016 Elsevier Inc. All rights reserved.