title: Drainage placement through the extraperitoneal tunnel can prevent its postoperative dislodgement effectively in laparoscopic rectal surgery.
abstract: BACKGROUND
  Drainage placement is frequently used in laparoscopic rectal surgery, and dislodgement is common in conventional transperitoneal drainage placement. We proposed that extraperitoneal tunnel for drainage placement is useful to prevent the dislodgement.
  
  
  METHODS
  We conducted an observational case-matched control study. In study group, a total of 40 patients undergoing laparoscopic rectal surgery with drainage through the extraperitoneal tunnel were enrolled. In control group, a total of 35 matched patients with drainage through the transperitoneal route were enrolled. Clinical data, tumor features, and intraoperative and postoperative characteristics were analyzed.
  
  
  RESULTS
  Ten patients had drainage dislodgement in the transperitoneal group (28%) and 4 patients in the extraperitoneal group (10%). The P value was 0.039. Postoperative recovery was faster in the extraperitoneal group than in the transperitoneal group, as reflected by a shorter time to diet (P=0.049) and postoperative length of stay (P=0.032). In a multivariate analysis, drain dislodgement had a significant impact on the time to diet (P=0.023) and the postoperative length of stay (P=0.037). Drain placement influenced the time to diet (P=0.055) and the postoperative length of stay (P=0.079).
  
  
  CONCLUSIONS
  In laparoscopic rectal surgery, drainage placement through the extraperitoneal tunnel can prevent its postoperative dislodgement effectively and is associated with better postoperative recovery.
authors.affiliation: Department of Surgery, Division of Colorectal Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC.
authors.forename: Jui-Ho
authors.initials: JH
authors.lastname: Wang
authors.forename: Tai-Ming
authors.initials: TM
authors.lastname: King
authors.forename: Min-Chi
authors.initials: MC
authors.lastname: Chang
authors.forename: Chao-Wen
authors.initials: CW
authors.lastname: Hsu
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D004322:Drainage / Q000379:methods*; D004868:Equipment Failure; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010537:Peritoneum; D011183:Postoperative Complications / Q000517:prevention & control*; D012004:Rectal Neoplasms / Q000601:surgery*; D012044:Regression Analysis