Is placement of pelvic drain indispensable after radical cystectomy, extended lymph node dissection, and orthotopic neobladder substitution?

Abstract

Aim: To evaluate the necessity of leaving a pelvic drain after open radical cystectomy. Materials and methods: Between January 2007 and January 2010, 58 patients with muscle-invasive bladder carcinoma were included. All patients underwent radical cystectomy, extended lymph node dissection, and orthotopic bladder (Studer pouch) substitution. Patients were randomized to have a pelvic drain catheter (Group 1, n = 22) or not (Group 2, n = 36). Ureteral catheters were removed at postoperative days 7 and 8. The pelvic drain catheters in Group 1 were removed when daily production was <100 mL. On postoperative day 21, the transurethral Foley catheter was removed after confirming no leakage on cystograms and cystostomy tubes were clamped, which in turn were removed on the next day after spontaneous voiding. Results: Mean patient ages in Groups 1 and 2 were 62.82 ± 9.13 and 61.72 ± 11.22 (P = 0.968), respectively. The duration of pelvic drainage with a catheter was 9.86 ± 1.32 days in Group 1. No statistically significant difference was observed in the hospital stay, recovery of intestinal peristalsis, postoperative creatinine and BUN levels, and postoperative early and late complications between groups. The mean follow-up period was 17.57 ± 7.59 months. Conclusion: Our limited experience shows that routine pelvic drainage seems not to be an indispensable part of open radical cystectomy and extended lymph node dissection with orthotopic bladder substitution, and it can safely be omitted. © TÜBİTAK.