Evaluation of Drain Placement Outcomes in Patients Requiring Splenectomy

Splenectomy is one of the most common abdominal surgeries following internal and hematologic diseases, as well as trauma which is along with some complications. This study aimed to investigate the effects and outcomes of drain placement after splenectomy, open splenorrhaphy, or laparoscopy.

This descriptive cross-sectional study included patients with various indications who underwent splenectomy with midline or left subcostal incisions in Besat Hospital, Hamadan, Iran, during 2017-2018. It should be noted that the patients underwent drain insertion, and the final outcomes were evaluated after surgery. Regarding the aim of the study, variables, such as hospital stay duration, postoperative infection, the incidence of collection and dehiscence, the duplication of surgical procedures, and secretion levels on days 1 to 5 post-operation were assessed using checklists and clinical examinations. All data were analyzed using SPSS software (version 21.0). A P-value less than 0.05 was considered statistically significant.

According to the results, the mean age of the patients was 42.12±20.26 years. Moreover, out of 31 patients under study, 21 cases were male. In total, 16 (51.6%) and 15 (48.4%) patients underwent splenectomy using subcostal and midline incisions, respectively. The indications for surgery in patients included idiopathic thrombocytopenic purpura (n=10, 32.3%), hemolytic anemia (n=2, 6.45%), trauma (n=7, 22.6%), spleen mass (n=2, 6.5%), diagnostic procedure (n=3, 9.7%), splenomegaly (n=5, 16.1%), and hematological problems along with biliary stone disease (n=2, 6.45%). Regarding the surgical complications, the wound site collection (n=6, 6.45%) and left sub-diaphragmatic and Morison's pouch collection (n=6, 19.35%) were reported in this study. It should be noted that the duplication of the surgery was performed only in one patient, and all the cases had drainage secretions until the third day.

The insertion of the drain after splenectomy not only prevents complications, such as hematoma, seroma, or pancreatic secretion collection below the left diaphragm but also informs the surgeon, in some cases, about bleeding after surgery. Therefore, it seems that the benefits of drain placement may outweigh the risks of not using it.