Is peritoneal drainage necessary in childhood perforated appendicitis?--a comparative study.
OBJECTIVE
In this study, we aimed to evaluate the effect of peritoneal drainage (PD) on postoperative infective complications in cases with perforated appendicitis.


METHODS
One hundred nine patients (with PD) were evaluated retrospectively and 117 cases (with no drainage [ND]) were evaluated prospectively regarding complications like wound infection (WI), intraabdominal abscess (IAA), and small bowel obstruction caused by adhesions (SBO) in perforated appendicitis cases. The abdomen was irrigated with isotonic NaCl solution and the wounds were closed primarily in all patients.


RESULTS
The total number of patients was 226 (male, 66.4%; female, 33.6%), with a mean age of 8.6 +/- 3.4 years (range, 1-15 years). The WI rates in PD and ND groups were 28.4% to 16.2%, respectively. The ratio of IAA in the PD group was 12.8% which decreased to 3.4% in the ND group. The difference was statistically significant (P < .05). The postoperative hospitalization period in the PD and ND groups were 10.2 +/- 6.5 and 8.3 +/- 3.3 days, durations of antibiotic use were 9.5 +/- 5.5 and 7.7 +/- 2.7 days, durations of NG tube usage were 3.2 +/- 1.5 and 2.2 +/- 1.2 days, time to oral feeding was 3.7 +/- 1.7 and 2.5 +/- 1.4 days, and time to normalization of the body temperatures was 3.7 +/- 2.3 vs 2.3 +/- 1.7 days. All differences were statistically significant (P < .05). The ratio of SBO increased from 2.8% to 3.4% in the ND group, but this result was not statistically significant.


CONCLUSIONS
As a result of this study, we recommend that peritoneal drainage should be abandoned in childhood appendicitis.
Narci
Adnan
A
Department of Pediatric Surgery, Dr. Sami Ulus Children's Hospital, Ankara, Turkey.
Karaman
Ibrahim
I
Karaman
Ayşe
A
Erdoğan
Derya
D
Cavuşoğlu
Yusuf Hakan
YH
Aslan
Mustafa Kemal
MK
Cakmak
Ozden
O
D018784:Abdominal Abscess / Q000453:epidemiology* / Q000517:prevention & control; D000293:Adolescent; D001062:Appendectomy / Q000009:adverse effects / Q000379:methods*; D001064:Appendicitis / Q000175:diagnosis / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D004322:Drainage / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007223:Infant; D007416:Intestinal Perforation / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D010533:Peritoneal Lavage / Q000706:statistics & numerical data*; D011336:Probability; D011446:Prospective Studies; D012189:Retrospective Studies; D018570:Risk Assessment; D012422:Rupture, Spontaneous / Q000601:surgery; D012720:Severity of Illness Index; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000517:prevention & control; D016896:Treatment Outcome