Drain Versus No-Drain in Patients After Surgery for Early Stage Gynecologic Malignancies: A Randomized Controlled Study

Abstract

Objective: This study compared rates of postoperative complications in patients, with early stage gynecologic malignancies, who had drains or no drains used after bilateral pelvic lymph node dissections (PLNDs), with or without para-aortic lymph-node dissections (LNDs). Materials and Methods: All willing patients, ages 18–70, with histologically proven gynecologic malignancies, who had PLNDs, with or without para-aortic LNDs, as a part of their primary surgeries, were randomized to have drains inserted or no drains inserted post surgery. Intraoperative details as well as postoperative length of drainage, hospital stays, and morbidity (wound complications, fluid accumulation needing intervention, hematomas, seromas, and lymphocysts) were noted. Patients were followed in 30 days post surgery, clinically and radiologically, to evaluate and compare morbidity in both groups. Results: A total of 144 cases were studied (73 in a drain group and 71 in a no-drain group). The average visual analogue score for pain was 6.7 in the drain group and 6.6 in the no-drain group (p = 0.44). The average postoperative hospital stay was 7 days in the drain group and 6 days in the no-drain, group (p = 0.014). There was no significant difference in other parameters (wound-infections, fluid accumulation needing intervention, seromas, lymphocysts, and paralytic ileus). Conclusions: Placing pelvic drains following surgeries routinely for early-stage gynecologic malignancies needs to be revisited as it confers no advantage, and by avoiding drains, patients can be discharged to go home earlier. (J GYNECOL SURG 20XX:000)