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The following is a summary of “Advantages comparison of peritoneal drainage versus no drainage after laparoscopic appendectomy for complicated appendicitis: a meta-analysis,” published in the November 2024 issue of Gastroenterology by Wu et al.
Peritoneal drainage (PD) following laparoscopic appendectomy (LA) has been considered beneficial for patients with complicated appendicitis, but recent research questions the effectiveness due to increased complications, longer recovery, and higher costs.
Researchers conducted a retrospective study to evaluate the efficacy and safety of PD vs. no peritoneal drainage (NPD) following LA for complicated appendicitis.
They reviewed studies from PubMed, Springer, and the Cochrane Library (January 1, 2000, to December 31, 2022), using the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. Primary outcomes included intra-abdominal abscess, intestinal obstruction, stump leakage, wound infection, and pain (visual analog scale [VAS] score), while secondary outcomes included operative time, recovery time, and hospitalization duration. Fixed- or random-effects models synthesized data depending on heterogeneity (I2 values), with pooled OR and weighted mean differences (WMD) for outcome comparison.
The results showed 12 studies with 3,374 cases, and the comparison of primary outcomes between PD and NPD showed that the incidence of wound infection and postoperative VAS score was significantly higher in the PD group (P<0.05). The comparison of secondary outcomes revealed that the operative duration, postoperative recovery time, and hospitalization duration were significantly longer in the PD group than in the NPD group (P<0.05).
They concluded that PD after LA for complicated appendicitis was not recommended due to increased complications and longer recovery time.
Source: bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-024-03500-8
