Drainage in the first postoperative days predicts intra-abdominopelvic complications

Abstract

Objective To explore the feasibility of early predicting intra-abdominopelvic infectious complications by closer observation of abdominal drainage. Methods Prospectively collected and evaluated the first-three-postoperative-day drainage samples of 207 up-to-standard patients underwent gastrointestinal surgery between April and September 2017 in Peking University Cancer Hospital. Among them, 159 males (76.8%) and 48 females (23.2%) were included, the average age was (59.9 ± 10.6) years and the average body mass index was (23.7 ± 3.2) kg/m2.Characteristics of the samples were daily recorded and later on matched with the clinical outcomes, including complications recorded and graded according to the Clavien-Dindo classification.The measurement data with normal distribution were presented as mean and standard deviation, the enumeration data were recorded in the form of quantity and percentage, using the χ2 test and Fisher accurate test. Results One hundred and ninty-nine patients (96.1%) were recorded as normal in the drainage samples, while the other 8 cases (3.9%) as abnormal (including pungent odor, purulent color etc.). There were 53 patients (25.6%) were diagnosed with postoperative complications. Among the patients with normal samples, the complication rate was 22.6%, while the eight abnormal ones were all diagnosed with postoperative complications (complication rate: 100.00%, P=0.000 012). Notably, among those 8 cases, complications were diagnosed much later than 3 days after surgery in 7 (87.5%) patients. In 1 (12.5%) case, the drainage abnormality was the only abnormal signs and there was no complications detected during the postoperative period of hospitalization. The intra-abdominal infectious complication occurred within 30 days after discharge and the patient re-admitted two times. Conclusions Early change of basic characteristics of postoperative drainage is a promising candidate for detection of postoperative complications with strong specificity. Clinical practice should be further regulated to ensure in-time recording and following interventions of those signs. Key words: Gastrointestinal neoplasms; Surgical procedures, operative; Postoperative complications; Predict; Drainage