Recognition of preventive abdominal drainage after laparoscopic appendectomy

Objective: To investigate the indication and position of preventive abdominal drainage after laparoscopic appendectomy( LA). Methods: One hundred and forty-six cases of LA were randomly divided into preventive drainage group( 71 cases) and non-drainage group( 75 cases). The leaving bed time,the time of anus exhaust,the recovery time of WBC,abdominal residual infection rate,the incidences of postoperative inflammatory ileus and hospital stay were compared between the two groups. 71 patients with preventive drainage were randomly divided into the right iliac fossa drainage group( group A 39 cases) through right middle abdominal incision and the pelvic cavity drainage group( group B 32 cases) through left lower abdominal incision. The infection rate of drainage incision,postoperative 24 h pain scores,total volume of drainage and abdominal residual infection rate were compared between the group A and B. Results: The leaving bed time,the time of anus exhaust and hospital stay were shorter in non-drainage patients,and the differences were statistical significant( P 0. 05). There was no difference in the recovery time of WBC to normal level,abdominal residual infection rate and the incidences of postoperative inflammatory ileus between the two groups( P 0. 05). The incisional infection rate and pain degree were significantly reduced in group B( P 0. 05). Total volume of drainage was significantly more than that of group A( P 0. 05). There was no difference in abdominal residual infection rate between the group A and B( P 0. 05). Conclusions: The conventional drainage tube is not advocated to be placed in LA for the suppurative appendicitis with localized peritonitis even diffuse peritonitis,as long as appendix root is treated satisfactorily,abdominal cavity is cleaned thoroughly. If drainage tube should be placed,it is suggested that drainage tube be placed in pelvic cavity through the incision of left lower quadrant.