A SYSTEMIC REVIEW OF META ANALYSIS OF DIFFERENT STUDIES OF DRAINAGE IN ABDOMINAL SURGERY
Creators: name: Dr. Dewat Ram Nakipuria
name: Dr. Ashish Moudgil
name: Dr.Vijay kumar
Publisher: name: Zenodo
Year: 2023
Subjects: Surgical Driange, Intra Abdominal Surgeries, Gastro Intestinal Surgeries.

description: Abstract
Background: Surgeons are often faced with the decision of whether or not to drain the peritoneal cavity after intra abdominal surgeries. Drainage removes collected blood, pus, bile or any fluid helping in postoperative good recovery but is associated with  unwanted pain,infections etc leading to more morbidity. Drains are often nonfunctional if not placed in proper cavity or recess, or displaced due to change in anatomical positions due to presence of intestinal loops & omentum or gets blocked  by thick collection or  may be expulsed due to loosening of externally fixed tie knot.So many surgeons argue that such intra adominal drain doesnot help. So the benefit of using a prophylactic drain after intra adominal surgeries is still controversial. Objective: of this systemic review of Meta analysis Studies of  drianage in Abdominal Surgeries is to derive a conclusion for using prophylactic drianage in abdominal surgeries. Methods: A systemic reviews of different Meta analysis studies on Surgical prophylactic drianage in abdominal gastrointestinal surgeries published from March 2011 till Feb 2023 in websites of Cochrane Database of Systematic Reviews, Medline, Pubmed, Scopus and EMBASE is being done.A manual search on health net web sites of search engine Google  & WHO on this topic was undertaken.In these studies,primary outcomes as abscess formation, wound infection,mortality and re-operation as well as  secondary outcomes as hospital stay, morbidity,quality of life and pain were assessed as a comparative study of 02 groups of patients one using intra abdominal  drianage and another without drianage in different abdominal surgeries. Result: In this systemic review,16 metaanalysis studies on intra abdominal drianage in abdominal surgeries has been included. Drainage did not improve outcomes after gastrointestinal surgeries such as distal pancreatectomy, appendectomy, liver resection, laparoscopic cholecystectomy,colorectal anastomoses, or anterior rectal resections etc. Rather,routine drainage caused harm to patients undergoing elective hepatectomy, laparoscopic cholecystectomy for non-complicated benign gallbladder, open cholecystectomy, and gastrectomy for gastric cancer as pain & wound infection increased in the drainage group resulting in increased morbidity and more hospital stay. The evidence of using drains after kidney transplantation, Roux-en-Y gastric bypass, and uro-oncologic surgery was low to draw conclusion and for pancreatoduodenectomy, drianage was helpful. Conclusions: This systemic review of  metaanalysis of different studies done in last 02 yrs reveal that prophylactic intra abdomainal driange doesnot improve post op complications except in operation as panceaticoduodenectomy ,rather may cause increase morbidity due to pain,infections but we cannot reach to a definite conclusion as lack of quality of researches available on this topic.So it is always a Surgeon's choice to put a driange or not after abdominal surgeries and further studies and reviews are needed for a conclusive guideline on this topic.