Evaluation of the selective use of abdomino-pelvic drains at laparoscopic myomectomy: in enhanced recovery, do drains delay discharge home?

Hurrell, Alice; Oliver, Reeba; Agarwal, Nilesh; Rouabhi, Schahrazed; Odejinmi, Funlayo

OBJECTIVE To assess whether the use of abdominal drains at laparoscopic myomectomy (LM) influences length of hospital stay. The primary outcome was to determine whether the use of intra-abdominal drains after LM was associated with prolonged hospital stay after surgery. Secondary outcomes were to identify factors that influence the use of abdomino-pelvic drains during LM. STUDY DESIGN Retrospective cohort study of 217 consecutive single surgeon LMs in a London university teaching hospital. Abdominal drains were used selectively after LM. Of the 217 patients, 123 (57%) had a drain left in situ at the end of the operation. RESULTS The two cohorts of patients were not significantly different in their demographics. The use of a drain was significantly associated with an increased number of fibroids (4.6±3.8 vs. 2.8±2.1, p<0.0001), increased weight of fibroids (277±211 g vs. 133±153 g, p<0.0001), increased surgical time (133±40 min vs. 90±35 min, p<0.0001) and increased estimated blood loss (406±265 ml vs. 199±98 ml, p<0.0001). There was no statistically significant difference in length of hospital stay (mean duration of admission 2.1 days±0.98 with drain, vs. 2.1 days±0.97 without a drain, p=0.98). CONCLUSION We conclude that although the use of a drain may be associated with a more complex operation, this does not delay the patient's discharge.