![]() To our knowledge, few studies have examined the association between pelvic drains and postoperative complications, mainly organ-space SSI, by focusing on drainage quantity and properties in clinical practice. However, these studies may be limited by the different types of drains used. Most studies defined the primary endpoint of placing surgical drains as the presence or absence of postoperative organ-space SSI. ![]() In cases of rectal resection with TME or TSME, some clinicians consider a pelvic drain as an effective measure against organ-space SSI due to suture failure, whereas others believe it has little effect. However, there are no scientific justifications for using pelvic drains to protect from organ-space SSI caused by colectomy suture failure, and there is a trend against their placement in recent years. Pelvic drains are often used during colorectal surgery to prevent and detect organ-space SSI and determine treatment. Organ-space SSI can delay wound healing, increase retreatment rates, increase postoperative mortality, and greatly affect long-term anorectal functions. Ĭonsequently, gastrointestinal suture failure, chyle leakage, or residual hematoma, conditions caused by intraoperative pelvic manipulation, are common causes of postoperative intra-abdominal infection, specifically, organ-space surgical site infection (SSI). However, anastomosis within 5 cm of the proximal side of the anal verge increases the risk of suture failure by 5.4–6.5 times compared with anastomosis > 5 cm away from the proximal side of the anal verge. Several opportunities for anastomosis are now accessible, not only on the distal side of the peritoneal reflection but also in the anal canal or anus. Crucial treatment strategies aimed at sphincter preservation are currently being implemented even if the tumors are located in the lower anorectum. Total mesorectal excision (TME) and tumor-specific mesorectal excision (TSME) are important procedures in colorectal surgery. The study protocol was retrospectively registered and carried out per the Declaration of Helsinki and approved by the Hiroshima University Institutional Review Board (approval number: E-2559). This supports early drain removal based on drainage quantity changes in actual clinical practice. It is not an effective diagnostic or therapeutic drain for organ-space SSI. The drainage quantity of negative-pressure closed suction drains diminishes shortly after surgery, regardless of the postoperative course. Four patients responded to therapeutic drains (3.3%). Drainage quality changes enabled diagnosis in two patients (1.6%). Drains were left in place in two patients after POD 3 owing to large drainage quantities. ![]() Twenty-one patients developed organ-space SSIs. The median (interquartile range) number of PODs before drain removal and organ-space surgical site infection (SSI) diagnosis were 3 (3‒5) and 7 (5‒8), respectively. ![]() Drainage quantity changes were observed on postoperative day (POD) 3, regardless of the surgical procedure or postoperative complications. Seventy-five patients (61.5%) and 47 patients (38.5%) underwent restorative proctectomy and proctocolectomy, respectively. Removal ensued following the absence of turbidity and a drainage quantity of ≤ 150 mL/day. After restorative proctectomy or proctocolectomy with gastrointestinal anastomosis, a continuous, low-pressure suction pelvic drain was placed and its contents measured. ![]() This retrospective single-center study enrolled 122 colorectal surgery patients between January 2017 and December 2020. This study aimed to investigate the association between the drainage quantity of pelvic drains and postoperative complications in colorectal surgery. ![]()
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