title: Surgical drain after open or laparoscopic splenectomy: is it needed or contraindicated?
abstract: OBJECTIVE
  The Authors report their experience with the routine use of surgical drainage in a large series of splenectomies.
  
  
  BACKGROUND
  Benefits and risks related to surgical drains have been always discussed, with some surgeons in favor of them and skeptic others considering not physiological their use. After splenectomy, their use is also largely debated, especially because of susceptibility of operated patients to infections.
  
  
  METHODS
  Two thousand nine cases have been reviewed. Indications for splenectomy, performed either by open or laparoscopic approach, included idiopathic thrombocytopenic purpura in 137 patients (65,4%), splenic lymphoma in 36 (17,2%), hereditary spherocytosis in 15 (7,4%), β-thalassemia in 8 (3,7%), other diseases in 13 (6,1%).
  
  
  RESULTS
  "Active" or "passive" drains were placed in 80% and 20% of cases, respectively. Drains were removed 2-3 days after surgery in 90,2%, within 10 days in 4,3%, within 2 months in 0,4% of cases. In 2 cases a post-operative bleeding, detected through the drainage, required re-operation. One patient developed a subphrenic abscess, successfully treated by a percutaneous drainage. One case of pancreatic fistula was observed.
  
  
  CONCLUSIONS
  In Authors' experience, the use of drains after splenectomy does not affect the risk of subsequent infectious complications, independently on the type of the drainage system used. Early removal of drains in this series might have played an important role in the very low incidence of abdominal infections reported. The use of surgical drains after splenectomy might play an important role to early detect post-operative bleeding, as it happened in 2 cases of this series.
authors.forename: R
authors.initials: R
authors.lastname: Vecchio
authors.forename: E
authors.initials: E
authors.lastname: Intagliata
authors.forename: S
authors.initials: S
authors.lastname: Marchese
authors.forename: S
authors.initials: S
authors.lastname: Battaglia
authors.forename: R R
authors.initials: RR
authors.lastname: Cacciola
authors.forename: E
authors.initials: E
authors.lastname: Cacciola
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D000075202:Contraindications; D004322:Drainage / Q000009:adverse effects / Q000295:instrumentation*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000601:surgery*; D011184:Postoperative Period; D012189:Retrospective Studies; D012307:Risk Factors; D013156:Splenectomy / Q000379:methods; D013158:Splenic Diseases / Q000601:surgery*; D016896:Treatment Outcome