Abstract：
Children undergoing appendicectomy for complicated appendicitis are at an increased risk of post-operative morbidity. Placement of an intra-peritoneal drain to prevent post-operative complications is controversial. We aimed to assess the efficacy of prophylactic drain placement to prevent complications in children with complicated appendicitis. A systematic review was performed in accordance with PRISMA guidelines. Cochrane, MEDLINE and Web of Science databases were searched from inception to November 2022 for studies directly comparing drain placement to no drain placement in children ≤ 18 years of age undergoing operative treatment of complicated appendicitis. A total of 5108 children with complicated appendicitis were included from 16 studies; 2231 (44%) received a drain. Placement of a drain associated with a significantly increased risk of intra-peritoneal abscess formation (odds ratio [OR] 1.61, 95% confidence interval [CI] 1.16-2.24, p = 0.004) but there was no significant difference in wound infection rate (OR 1.46, 95% CI 0.74-2.88, p = 0.28). Length of stay was significantly longer in the drain group (mean difference 2.02 days, 95% CI 1.14-2.90, p < 0.001). Although the quality and certainty of the available evidence is low, prophylactic drain placement does not prevent intra-peritoneal abscess following appendicectomy in children with complicated appendicitis.
摘要：
因复杂阑尾炎而接受阑尾切除术的儿童术后发病率增加。放置腹膜内引流管以防止术后并发症是有争议的。我们旨在评估预防性引流管放置以预防复杂性阑尾炎患儿并发症的疗效。根据PRISMA指南进行系统评价。科克伦,从开始到2022年11月，搜索了MEDLINE和WebofScience数据库，以直接比较在接受复杂性阑尾炎手术治疗的年龄≤18岁的儿童中引流器放置与无引流器放置的研究。从16项研究中纳入了5108名患有复杂性阑尾炎的儿童；2231名（44％）接受了引流。引流的放置与腹膜内脓肿形成的风险显着增加相关（比值比[OR]1.61，95％置信区间[CI]1.16-2.24，p=0.004），但伤口感染率没有显着差异（OR1.46，95％CI0.74-2.88，p=0.28）。引流组的住院时间明显更长(平均差2.02天，95%CI1.14-2.90，p<0.001)。尽管现有证据的质量和确定性较低，预防性引流并不能预防复杂阑尾炎患儿阑尾切除术后的腹膜内脓肿。
