Peritoneal Drains in Perforated Appendicitis without Peritonitis: A Prospective Randomized Controlled Study.
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Date
2011Author
Jani, P G
Nyaga, P N
Type
ArticleLanguage
enMetadata
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Background: Appendicitis is recognized worldwide as the commonest surgical
emergency. Its management becomes more challenging when the patient presents with
perforated appendicitis In the western world To determine the value of peritoneal drains
in patients operated with an appendicular pathology more advanced then simple acute
appendicitis (referred as advanced appendicular pathology). Patients with generalized
peritonitis secondary to an appendicular pathology were excluded.
Methods: This was a randomized prospective study of acute appendicitis patients seen at
the Accident and Emergency Department or in the surgical wards at Kenyatta National
Hospital (KNH) over 12 months period.
Results: Of the 216 patients diagnosed with acute appendicitis, 117 patients had simple
acute appendicitis without perforation and were therefore excluded from the study.
Ninety seven patients had various stages of advanced appendicular pathology. Seven had
generalized peritonitis and were also excluded. The remaining 90 patients constituted
our study population. These were equally randomized to two groups. Forty five had the
closed system of tube drainage provided (without suction) while the remaining 45 had no
drain inserted. All of the 90 patients included in the study had histological confirmation
of an inflamed perforated appendix. Postoperatively, 18 patients had wound sepsis and 6
patients had other complications including faecal fistula, abdominal abscess, and paralytic
ileus. Out of those with wound sepsis, the majority (83%) were in the drain group. All
patients with other complications belonged to the drain group. The patients in the drain
group had significantly longer duration of antibiotic use and hospital stay.
Conclusion: The findings in this study showed an increased complications rate, prolonged
use of antibiotics and hospital stay in patients with drains operated for an advanced
appendicular pathology.
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http://www.ajol.info/index.php/ecajs/article/view/72508http://erepository.uonbi.ac.ke:8080/xmlui/handle/123456789/34092
Citation
Jani, P. G., and P. N. Nyaga. "Peritoneal Drains in Perforated Appendicitis without Peritonitis: A Prospective Randomized Controlled Study." East and Central African Journal of Surgery 16.2 (2011): 62-71.Publisher
Department of Veterinary Pathology, Microbiology and Parasitology, University of Nairobi
Description
Journal article