title: The use of surgical drains in laparoscopic splenectomies Consideration on a large series of 117 consecutive cases.
abstract: BACKGROUND
  The use of surgical drains after traditional splenectomy has been largely debated and several Authors have been unfavorable to their use. With the advent of laparoscopic splenectomy, their role has been re-discussed. The increased risk of undetectable pancreatic, gastric or colon injury in challenging laparoscopic removal of the spleen have induced some surgeons to reconsider the advantages related to their use.
  
  
  METHODS
  One hundred seventeen consecutive cases of laparoscopic splenectomy with routine use of surgical drains have been reviewed. Indications for surgery, length of operations, post-operative day of drain removal, post-operative complications were retrospectively analyzed.
  
  
  RESULTS
  Laparoscopic splenectomy was performed for idiopathic thrombocytopenic purpura in 77 patients (65,8%), splenic lymphoma in 11 (9,4%), hereditary spherocytosis in 12 (10,2%), β-thalassemia in 6 (5.1%), other diseases in 11 (9,4%) cases. Conversion to open surgery was necessary in 11,1% of cases. Drains were removed 2-3 days after surgery in 95,8%, within 10 days in 3.4%, within 2 months in 0,8% of cases. In 2 cases a post-operative bleeding, detected through the drainage, required re-operation. One patient with myelofibrosis and massive splenomegaly developed a late post-operative subphrenic abscess, successfully treated by a percutaneous drainage.
  
  
  CONCLUSIONS
  In Authors' experience, the use of drains after laparoscopic splenectomy helped detect early post-operative bleeding. Surgical drains could reduce the incidence of fluid intra-abdominal collections and infections. Their use should be recommended in the laparoscopic approach, especially in technically demanding surgical procedures.
  
  
  BACKGROUND
  Laparoscopy, Surgical drainage, Splenectomy.
authors.forename: Rosario
authors.initials: R
authors.lastname: Vecchio
authors.forename: Eva
authors.initials: E
authors.lastname: Intagliata
authors.forename: Salvatore
authors.initials: S
authors.lastname: Marchese
authors.forename: Emma
authors.initials: E
authors.lastname: Cacciola
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D061887:Conversion to Open Surgery; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis; D019106:Postoperative Hemorrhage / Q000175:diagnosis*; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000601:surgery; D012086:Reoperation; D013156:Splenectomy / Q000379:methods*; D013158:Splenic Diseases / Q000601:surgery; D013369:Subphrenic Abscess / Q000175:diagnosis / Q000601:surgery; D013396:Suction / Q000706:statistics & numerical data*; D055815:Young Adult