title: Evaluation of the selective use of abdomino-pelvic drains at laparoscopic myomectomy: in enhanced recovery, do drains delay discharge home?
abstract: OBJECTIVE
  To assess whether the use of abdominal drains at laparoscopic myomectomy (LM) influences length of hospital stay. The primary outcome was to determine whether the use of intra-abdominal drains after LM was associated with prolonged hospital stay after surgery. Secondary outcomes were to identify factors that influence the use of abdomino-pelvic drains during LM.
  
  
  METHODS
  Retrospective cohort study of 217 consecutive single surgeon LMs in a London university teaching hospital. Abdominal drains were used selectively after LM. Of the 217 patients, 123 (57%) had a drain left in situ at the end of the operation.
  
  
  RESULTS
  The two cohorts of patients were not significantly different in their demographics. The use of a drain was significantly associated with an increased number of fibroids (4.6±3.8 vs. 2.8±2.1, p<0.0001), increased weight of fibroids (277±211 g vs. 133±153 g, p<0.0001), increased surgical time (133±40 min vs. 90±35 min, p<0.0001) and increased estimated blood loss (406±265 ml vs. 199±98 ml, p<0.0001). There was no statistically significant difference in length of hospital stay (mean duration of admission 2.1 days±0.98 with drain, vs. 2.1 days±0.97 without a drain, p=0.98).
  
  
  CONCLUSIONS
  We conclude that although the use of a drain may be associated with a more complex operation, this does not delay the patient's discharge.
authors.affiliation: Department of Gynaecology, Whipps Cross University Hospital, Barts Health Trust, London E11 1NR, UK.
authors.forename: Alice
authors.initials: A
authors.lastname: Hurrell
authors.affiliation: Department of Gynaecology, Whipps Cross University Hospital, Barts Health Trust, London E11 1NR, UK.
authors.forename: Reeba
authors.initials: R
authors.lastname: Oliver
authors.affiliation: Department of Gynaecology, Northwick Park Hospital, London HA1 3UJ, UK.
authors.forename: Nilesh
authors.initials: N
authors.lastname: Agarwal
authors.affiliation: Department of Gynaecology, Whipps Cross University Hospital, Barts Health Trust, London E11 1NR, UK.
authors.forename: Schahrazed
authors.initials: S
authors.lastname: Rouabhi
authors.affiliation: Department of Gynaecology, Whipps Cross University Hospital, Barts Health Trust, London E11 1NR, UK. Electronic address: funlayo.odejinmi@bartsandthelondon.nhs.uk.
authors.forename: Funlayo
authors.initials: F
authors.lastname: Odejinmi
mesh_terms: D000328:Adult; D004322:Drainage / Q000295:instrumentation* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D063186:Uterine Myomectomy / Q000295:instrumentation* / Q000706:statistics & numerical data
keywords: Intra-abdominal drain; Laparoscopy; Myomectomy