Residual pelvic fluid using two types of drains at laparoscopy: a randomized controlled trial.

Abstract

To compare the estimated residual pelvic fluid volume in women receiving suction or nonsuction drains after gynecologic laparoscopic surgery using transvaginal ultrasonography. In this randomized comparative study of women undergoing a laparoscopic surgical procedure for benign gynecologic conditions, women requiring postoperative drainage were assigned to receive either a suction or a nonsuction drain. Immediately before drain removal, women had transvaginal ultrasonography and estimation of the residual fluid volume using the formula pi/6 x D(1) x D2 x D(3), where D(1) and D(2) were obtained in the sagittal plane and D(3) in the coronal plane. Sixty-nine women consented to the study; 51 received a drain, and 47 complete data sets were obtained. The two groups had similar demography, and no complications were reported intraoperatively or postoperatively. The median volume of fluid drained postoperatively was not significantly different: 170.0 mL (range 5-1,370 mL) for nonsuction and 160.0 mL (range 10-550 mL) for suction. The median residual fluid volume estimated in the pelvis postoperatively by transvaginal ultrasonography was 0.24 mL (interquartile range 0.00-2.45) in the nonsuction group versus 1.91 mL (interquartile range 0.32-7.72) in the suction group. This was statistically different (z=-2.10, P=.04) for nonsuction versus suction drains. There is a statistically reduced residual fluid volume using nonsuction drains after laparoscopic surgery. However, with both types of drain, these residual volumes are well below what is considered physiologic, and there is likely little clinical difference. Both nonsuction and suction drains are equally effective in removing fluid from the peritoneal cavity after gynecologic laparoscopic surgery. Australian New Zealand Clinical Trials Registry, www.anzctr.org.au, ACTRN12608000109303. I.