{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T02:35:54Z","timestamp":1792290954343,"version":"4.4.0"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T00:00:00Z","timestamp":1752796800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The utility of abdominal drainage is common in laparoscopic appendectomy (LA) for acute appendicitis with perforation to prevent postoperative complications, such as intraabdominal abscess (IAA) and stump fistula. Nevertheless, the drain tube placement is considered to be associated with postoperative IAA formation in cases of complicated appendicitis. Our study aims to determine whether early removal of abdominal drainage tube after LA can improve prognosis for patients with perforated appendicitis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 182 patients who underwent abdominal drainage tube placement during LA due to acute appendicitis with perforation were divided into experimental group and control group by random number table method, including 87 patients in the experimental group and 95 patients in the control group. Patients in the experimental group had their abdominal drainage tube removed within 48\u2005h after surgery. Patients in the control group removed the drainage tube after 48\u2005h routinely. Variables of demographic and clinical characteristics of these patients between the two groups were analyzed. Postoperative outcomes, including overall complications, IAA, superficial surgical site infection (SSI), stump fistula, ileus, bleeding, postoperative length of stay (LOS), hospitalization costs and readmission to hospital, were compared.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>These two groups were similar regarding demographic and perioperative clinical characteristics like age, sex, duration of symptoms and hematological examination indicators (<jats:italic>P<\/jats:italic>\u2009&amp;gt;\u20090.05). Although there was no significant difference in superficial SSI and ileus between the two groups (<jats:italic>P<\/jats:italic>\u2009&amp;gt;\u20090.05), patients in the experimental group was associated with a lower rate of overall complications (3.4% vs. 17.9%, <jats:italic>P<\/jats:italic>\u2009=\u20090.002), declined incidence of IAA (3.4% vs. 11.6%, <jats:italic>P<\/jats:italic>\u2009=\u20090.040), a shorter LOS [4 (4,4) vs. 6 (5,6) days, <jats:italic>P<\/jats:italic>\u2009&amp;lt;\u20090.001] and less hospitalization costs [9,705 (8,621\u221210,402) vs. 10,851 (9,704\u221211,752) CNY, <jats:italic>P<\/jats:italic>\u2009&amp;lt;\u20090.001] compared with patients in the control group. No stump fistula and intraabdominal bleeding occurred in both groups. There was no significant difference in readmission rate within 30 days after surgery between the two groups (<jats:italic>P<\/jats:italic>\u2009=\u20090.684).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>It is safe and effective to remove abdominal drainage tube within 48\u2005h after LA for patients with perforated appendicitis. This approach can accelerate the recovery time, decline the incidence of IAA and reduce hospitalization costs.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fsurg.2025.1617312","type":"journal-article","created":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T14:06:12Z","timestamp":1752847572000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Comparison of early vs. routine removal of abdominal drainage tube after laparoscopic appendectomy for perforated appendicitis: a retrospective cohort study"],"prefix":"10.3389","volume":"12","author":[{"given":"Jun","family":"He","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gang","family":"Qian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yefei","family":"Mao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Gao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,7,18]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"2299","DOI":"10.1001\/jama.2021.20502","article-title":"Diagnosis and management of acute appendicitis in adults: a review","volume":"326","author":"Moris","year":"2021","journal-title":"JAMA"},{"key":"B2","doi-asserted-by":"publisher","first-page":"463","DOI":"10.1097\/SLE.0b013e318262edf1","article-title":"Laparoscopy grading system of acute appendicitis: new insight for future trials","volume":"22","author":"Gomes","year":"2012","journal-title":"Surg Laparosc Endosc Percutan Tech"},{"key":"B3","doi-asserted-by":"publisher","first-page":"578","DOI":"10.1016\/j.jamcollsurg.2017.12.046","article-title":"Appendicitis grade, operative duration, and hospital cost","volume":"226","author":"Collins","year":"2018","journal-title":"J Am Coll Surg"},{"key":"B4","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1186\/s12876-016-0453-0","article-title":"Evidence of surgical outcomes fluctuates over time: results from a cumulative meta-analysis of laparoscopic versus open appendectomy for acute appendicitis","volume":"16","author":"Ukai","year":"2016","journal-title":"BMC Gastroenterol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1186\/s13017-020-00306-3","article-title":"Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines","volume":"15","author":"Di Saverio","year":"2020","journal-title":"World J Emerg Surg"},{"key":"B6","doi-asserted-by":"publisher","first-page":"394","DOI":"10.1016\/j.jpedsurg.2021.07.005","article-title":"Laparoscopic versus open appendicectomy for complicated appendicitis in children: a systematic review and meta-analysis","volume":"57","author":"Neogi","year":"2022","journal-title":"J Pediatr Surg"},{"key":"B7","doi-asserted-by":"publisher","first-page":"2974","DOI":"10.1007\/s00464-024-10813-y","article-title":"SAGES Guideline for the diagnosis and treatment of appendicitis","volume":"38","author":"Kumar","year":"2024","journal-title":"Surg Endosc"},{"key":"B8","doi-asserted-by":"publisher","first-page":"14793","DOI":"10.1038\/s41598-019-51172-2","article-title":"Risk factors for serious morbidity, prolonged length of stay and hospital readmission after laparoscopic appendectomy\u2014results from Pol-LA (Polish laparoscopic appendectomy) multicenter large cohort study","volume":"9","author":"Wal\u0119dziak","year":"2019","journal-title":"Sci Rep"},{"key":"B9","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1186\/s13017-022-00421-3","article-title":"The necessity of abdominal drainage for patients with complicated appendicitis undergoing laparoscopic appendectomy: a retrospective cohort study","volume":"17","author":"Liao","year":"2022","journal-title":"World J Emerg Surg"},{"key":"B10","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1007\/s00383-023-05457-3","article-title":"Drain placement in paediatric complicated appendicitis: a systematic review and meta-analysis","volume":"39","author":"Neville","year":"2023","journal-title":"Pediatr Surg Int"},{"key":"B11","doi-asserted-by":"publisher","first-page":"3571","DOI":"10.1007\/s00464-024-10869-w","article-title":"The utility of intraperitoneal drain placement after laparoscopic appendectomy for perforated appendicitis in postoperative intraperitoneal abscess prevention","volume":"38","author":"Alabbad","year":"2024","journal-title":"Surg Endosc"},{"key":"B12","doi-asserted-by":"publisher","first-page":"411","DOI":"10.1186\/s12876-024-03500-8","article-title":"Advantages comparison of peritoneal drainage versus no drainage after laparoscopic appendectomy for complicated appendicitis: a meta-analysis","volume":"24","author":"Wu","year":"2024","journal-title":"BMC Gastroenterol"},{"key":"B13","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1186\/s13017-021-00380-1","article-title":"Acute abdomen in the immunocompromised patient: WSES, SIS-E, WSIS, AAST, and GAIS guidelines","volume":"16","author":"Coccolini","year":"2021","journal-title":"World J Emerg Surg"},{"key":"B14","doi-asserted-by":"publisher","first-page":"962","DOI":"10.1007\/s11605-020-04610-w","article-title":"Variation in drain management among patients undergoing major hepatectomy","volume":"25","author":"Sahara","year":"2021","journal-title":"J Gastrointest Surg"},{"key":"B15","doi-asserted-by":"publisher","first-page":"e307","DOI":"10.1097\/SLA.0000000000004992","article-title":"Early drain removal is safe in patients with low or intermediate risk of pancreatic Fistula after pancreaticoduodenectomy: a multicenter, randomized controlled trial","volume":"275","author":"Dai","year":"2022","journal-title":"Ann Surg"},{"key":"B16","doi-asserted-by":"publisher","first-page":"560","DOI":"10.5114\/wiitm.2021.103942","article-title":"Comparison of intra-abdominal abscess formation after laparoscopic and open appendectomy for complicated and uncomplicated appendicitis: a retrospective study","volume":"16","author":"Mulita","year":"2021","journal-title":"Wideochir Inne Tech Maloinwazyjne"},{"key":"B17","doi-asserted-by":"publisher","first-page":"246","DOI":"10.1007\/s00423-024-03421-w","article-title":"Risk factors for developing intra-abdominal abscess following appendicectomy for acute appendicitis: a retrospective cohort study","volume":"409","author":"Mao","year":"2024","journal-title":"Langenbecks Arch Surg"},{"key":"B18","doi-asserted-by":"publisher","first-page":"1078","DOI":"10.1177\/000313481408001036","article-title":"Role of drains in laparoscopic appendectomy for complicated appendicitis at a busy county hospital","volume":"80","author":"Pakula","year":"2014","journal-title":"Am Surg"},{"key":"B19","doi-asserted-by":"publisher","first-page":"1291","DOI":"10.1007\/s00383-022-05155-6","article-title":"Laparoscopic appendectomy for complicated appendicitis in children: does the post-operative peritoneal drain make any difference? A pilot prospective randomised controlled trial","volume":"38","author":"Human","year":"2022","journal-title":"Pediatr Surg Int"},{"key":"B20","doi-asserted-by":"publisher","first-page":"e599","DOI":"10.1097\/SLA.0000000000003804","article-title":"Abdominal drainage at appendectomy for complicated appendicitis in children: a propensity-matched comparative study","volume":"274","author":"Fujishiro","year":"2021","journal-title":"Ann Surg"},{"key":"B21","doi-asserted-by":"publisher","first-page":"CD010168","DOI":"10.1002\/14651858.CD010168.pub5","article-title":"Abdominal drainage to prevent intraperitoneal abscess after appendectomy for complicated appendicitis","volume":"4","author":"Tang","year":"2025","journal-title":"Cochrane Database Syst Rev"},{"key":"B22","doi-asserted-by":"publisher","first-page":"CD010168","DOI":"10.1002\/14651858.CD010168.pub4","article-title":"Abdominal drainage to prevent intra-peritoneal abscess after appendectomy for complicated appendicitis","volume":"8","author":"Li","year":"2021","journal-title":"Cochrane Database Syst Rev"},{"key":"B23","doi-asserted-by":"publisher","first-page":"1086877","DOI":"10.3389\/fsurg.2022.1086877","article-title":"Prophylactic abdominal drainage following appendectomy for complicated appendicitis: a meta-analysis","volume":"9","author":"Liao","year":"2023","journal-title":"Front Surg"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.23736\/S2724-5276.24.07483-4","article-title":"Use of drainage after laparoscopic complicated appendectomy in children: a single-center experience","author":"Voglino","year":"2024","journal-title":"Minerva Pediatr (Torino)"},{"key":"B25","doi-asserted-by":"publisher","first-page":"1028","DOI":"10.1177\/000313481608201038","article-title":"Appendicitis in cancer patients is often observed and can represent appendiceal malignancy","volume":"82","author":"Santos","year":"2016","journal-title":"Am Surg"},{"key":"B26","doi-asserted-by":"publisher","first-page":"501","DOI":"10.1097\/TA.0000000000003028","article-title":"Managing acute uncomplicated appendicitis in frail geriatric patients: a second hit may be too much","volume":"90","author":"Chehab","year":"2021","journal-title":"J Trauma Acute Care Surg"},{"key":"B27","doi-asserted-by":"publisher","first-page":"283","DOI":"10.11604\/pamj.2020.36.283.24834","article-title":"Roseomonas gilardii in patient with leukemia and acute appendicitis: case report and review","volume":"36","author":"Mulita","year":"2020","journal-title":"Pan Afr Med J"}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2025.1617312\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T14:06:13Z","timestamp":1752847573000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2025.1617312\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,18]]},"references-count":27,"alternative-id":["10.3389\/fsurg.2025.1617312"],"URL":"https:\/\/doi.org\/10.3389\/fsurg.2025.1617312","relation":{},"ISSN":["2296-875X"],"issn-type":[{"value":"2296-875X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,18]]},"article-number":"1617312"}}