EARLY REMOVAL OF POST-OPERATIVE ABDOMINAL DRAIN AFTER RENAL TRANSPLANT IN PATIENTS WITH SIGNIFICANT LYMPHORRHOEA: RESULTS OF A SINGLE CENTRE OBSERVATIONAL STUDY
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2018, Vol 5, Issue 34
Abstract
BACKGROUND Delay in post-operative abdominal drain removal due to excessive lymphorrhoea can lead to prolonged hospital stay and increase in risk of infections in patients with kidney transplant. This study was designed to evaluate outcomes and cost effectiveness of early drain removal in renal transplant recipients with significant lymphorrhoea. MATERIALS AND METHODS In this retrospective observational study, kidney transplant recipients in whom abdominal drain was removed despite lymphorrhoea output of more than 200 ml/ day for five consecutive post-operative days were included in the ‘early drain removal group’ (EDR). Five patients who had a drain output of more than 200 ml/day for five consecutive post-operative days but who had the drain removed as per traditional practice i.e. after output went below 50 ml were included in the ‘late drain removal group’ (LDR). The patients were observed closely for any wound complications or development of lymphocoele. Patients were followed with ultrasound scans at four weeks, three months and six months. Incidence of perinephric collection or lymphocoele was recorded. RESULTS A total of ten patients (9 males) were included in the study (EDR group n=5; mean (±SD) age 44.8 (±5.50) years; LDR group n=5; mean (±SD) age 41.4 (±8.41) years). Comorbidities in both groups were similar. Induction was used in four patients in the EDR group and all patients in the LDR group. The maintenance immunosuppressive therapy used in all patients was similar. The difference in drain output till five days was not significant between two groups (day 1- p=0.757, day 2- p=1; day 3- p=0.860; day 4-p=0.436; day 5-p=0.553). There were no post-operative complications or post-drain removal wound complication in any of the patients in both the groups. Mean (±SD) duration of hospital stay in EDR group and LDR group was 8.2 (±0.45) and 12.8 (±1.30) days respectively (p=0.001). Early removal of drain was associated with reduction in the overall cost of therapy. CONCLUSION Early removal of drain may be a satisfactory, cost-effective and feasible option in kidney transplant recipients. A larger, prospective study is desired.
Authors and Affiliations
Shrirang Bichu, Parag Vasant Tilve, Umesh Oza, Sadanand W. Thatte, Ashok L Kirpalani, Dilip Ashok Kirpalani, Vivek Ganesh Jadhao
Keywords
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- EP ID EP571042
- DOI 10.18410/jebmh/2018/510
- Views 98
- Downloads 0
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