Effectiveness and Complications of Surgical Drainage in Pediatric Surgery: A Literature Review

Authors

  • Harsali Lampus Universitas Sam Ratulangi
  • Candy Candy Universitas Sam Ratulangi
  • Odwin B. Saumur Universitas Sam Ratulangi

DOI:

https://doi.org/10.35790/msj.v8i2.65819

Keywords:

surgical drainage; complications; effectiveness; pediatric surgery

Abstract

Abstract: The use of surgical drainage is a common adjunctive procedure in various pediatric surgeries. However, its effectiveness and associated risks remain a subject of debate, particularly due to variations in drain types, surgical techniques, and the unique characteristics of pediatric patients. This study aimed to evaluate the effectiveness and complications of surgical drainage in various pediatric surgical procedures based on the most recent literature. This narrative literature review was compiled from articles published in the last 10 years (2015–2025), sourced from reputable databases such as PubMed, Cochrane, EBSCO, and Google Scholar. Inclusion criteria encompassed studies involving pediatric patients aged 0–18 years undergoing thoracic, abdominal, ocular, or spinal surgeries, addressing the use of surgical drainage either as a primary intervention or in comparison to non-drain approaches. A total of 20 studies were analyzed in this review. Overall, drainage proved most effective in thoracic and ocular surgeries. In thoracic surgery, devices such as the Thopaz digital drain shortened hospital stays, accelerated recovery, and reduced the number of postoperative radiographs. In ocular surgery, glaucoma drainage devices (GDD) effectively controlled intraocular pressure (IOP) and reduced the need for re-intervention. Conversely, in abdominal surgeries such as appendectomy and laparoscopic pyeloplasty, as well as spinal surgeries, drainage did not confer significant clinical benefits in reducing complications or accelerating recovery. Complications in thoracic surgery included minimal risks such as prolonged air leaks and empyema; in ocular surgery, hypotony, bleb encapsulation, infection, and tube revision were most common; in abdominal surgery, complications included infection, intra-abdominal abscess, bowel obstruction, iatrogenic leaks, peritonitis, and hernia; while in spinal surgery, complications consisted of superficial infections, wound dehiscence, neurological deficits, and hematoma. In conclusion, surgical drainage is most effective in thoracic and ocular surgeries in terms of success rate, accelerated recovery, and reduced length of hospital stay. However, in abdominal and spinal surgeries, drainage offers no significant clinical benefit and carries potential risks of complications.

Keywords: surgical drainage; complications; effectiveness; pediatric surgery

Author Biographies

Harsali Lampus, Universitas Sam Ratulangi

Division of Pediatric Surgery, Department of Surgery, Faculty of Medicine, Universitas Sam Ratulangi - Prof. Dr. R. D. Kandou General Hospital, Manado, Indonesia

Candy Candy, Universitas Sam Ratulangi

Division of Pediatric Surgery, Department of Surgery, Faculty of Medicine, Universitas Sam Ratulangi - Prof. Dr. R. D. Kandou General Hospital, Manado, Indonesia

Odwin B. Saumur, Universitas Sam Ratulangi

Department of Surgery, Faculty of Medicine, Universitas Sam Ratulangi, Manado, Indonesia

References

1. Shen Y, Lin Y, Fang YF, Wu DM, He YB. Efficacy of peritoneal drainage in very-low-birth-weight neonates with Bell’s stage II necrotizing enterocolitis: A single-center retrospective study. World J Gastrointest Surg. 2023;15(7):1416–22. Available from: https://www.wjgnet.com/1948-9366/full/v15/i7/1416.htm

2. Frediani S, Romano G, Pardi V, Aloi IP, Bertocchini A, Accinni A, et al. Benefits of using digital thoracic drainage systems for post-operative treatment in pediatric populations: personal experience and review of literature. Front Pediatr. 2023;11:1280834. Doi: https://doi.org/10.3389/fped.2023.1280834

3. Pérez-Egido L, García-Casillas MA, Simal I, Fanjul M, Cañizo A, Cerdá JA, et al. Digital thoracic drainage: a new system to monitor air leaks in pediatric population. J Pediatr Surg. 2019;54(4):693–5. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0022346818307279

4. Ghestem T, Carolina D, Chappey B, Klein C, Haraux E. Evaluation of the K-wire technique for external urinary drainage in pediatric laparoscopic pyeloplasty. Pediatri Urol. 2023;19(5): 639.e1-639.e4. Available from: https://linkinghub.elsevier.com/retrieve/pii/S1477513123002371

5. Kaushik S, Kataria P, Raj S, Pandav SS, Ram J. Safety and efficacy of a low-cost glaucoma drainage device for refractory childhood glaucoma. Br J Ophthalmol. 2017;101(12):1623–7. Doi: https://bjo.bmj.com/ lookup/doi/10.1136/bjophthalmol-2017-310276

6. Aneiros Castro B, Cano I, García A, Yuste P, Ferrero E, Gómez A. Abdominal drainage after laparoscopic appendectomy in children: an endless controversy? Scand J Surg. 2018;107(3):197–200. Doi: https://journals.sagepub.com/doi/10.1177/1457496918766696

7. David VL, Ciornei B, Popoiu MC, Iacob RE, Boia ES. Is there a role for prophylactic drainage of the abdominal cavity after laparoscopic appendectomy for non-complicated appendicitis in children? J Ped Endosc Surg. 2019;1(2):71–4. Available from: http://link.springer.com/10.1007/s42804-019-00014-z

8. Gorter RR, Meiring S, Van Der Lee JH, Heij HA. Intervention not always necessary in post-appendectomy abscesses in children; clinical experience in a tertiary surgical centre and an overview of the literature. Eur J Pediatr. 2016;175(9):1185–91. Available from: http://link.springer.com/10.1007/s00431-016-2756-0

9. Costa Jr ADS, Bachichi T, Holanda C, Rizzo LALMD. An initial experience with a digital drainage system during the postoperative period of pediatric thoracic surgery. J Bras Pneumol. 2016;42(6):444–6. Available from: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1806-37132016000600444&lng=en&tlng=en

10. Vasconcelos-Castro S, Borges-Dias M, Soares-Oliveira M. Digital thor acic dr ainage system: a new tool for pediatric thoracic surgery. Cardiac Thorasic aand Vascular Surgery. 2022;29(4):21-5. Doi: https://doi.org/10.48729/pjctvs.213

11. Voglino V, Frediani S, Aloi IP, Pardi V, Bertocchini A, Accinni A, et al. Use of drainage after laparoscopic complicated appendectomy in children: a single-center experience. Minerva Pediatr (Torino). 2024;Sep. Available from: https://www.minervamedica.it/index2.php?show=R15Y9999N00A24091903

12. Human M, Tshifularo N, Mabitsela M. Laparoscopic appendectomy for complicated appendicitis in children: Does the post-operative peritoneal drain make any difference? A prospective randomised control trial. Research Square Platform LLC. 2022 Available from: https://www.researchsquare.com/article/rs-1563462/v1

13. Mandalos A, Sung V. Glaucoma drainage device surgery in children and adults: a comparative study of outcomes and complications. Graefes Arch Clin Exp Ophthalmol. 2017;255(5):1003–11. Available from: http://link.springer.com/10.1007/s00417-017-3584-2

14. Nazirova ZR, Turakulova DM, Buzrukov SB. Surgical treatment of congenital glaucoma in children using Glautex drainage. Vestn oftal’mol. 2020;136(6):202. Available from: http://www.mediasphera.ru/ issues/vestnik-oftalmologii/2020/6/10042465X2020062202

15. Chen A, Yu F, Law SK, Giaconi JA, Coleman AL, Caprioli J. Valved glaucoma drainage devices in pediatric glaucoma: retrospective long-term outcomes. JAMA Ophthalmol. 2015;133(9):1030. Available from: http://archopht.jamanetwork.com/article.aspx?doi=10.1001/jamaophthalmol.2015.1856

16. Esfandiari H, Kurup SP, Torkian P, Mets MB, Rahmani B, Tanna AP. Long-term clinical outcomes of Ahmed and Baerveldt drainage device surgery for pediatric glaucoma following cataract surgery. Journal of Glaucoma. 2019;28(10):865–70. Available from: https://journals.lww.com/10.1097/ IJG.0000000000001335

17. Puthuran GV, Palmberg PF, Wijesinghe HK, Pallamparthy S, Krishnadas S, Robin AL. Intermediate-term outcomes of Aurolab aqueous drainage implant in refractory paediatric glaucoma. Br J Ophthalmol. 2020;104(7):962–6. Available from: https://bjo.bmj.com/lookup/doi/10.1136/bjophthalmol-2019-314399

18. Helenius L, Gerdhem P, Ahonen M, Syvänen J, Jalkanen J, Charalampidis A, et al. Postoperative outcomes of pedicle screw instrumentation for adolescent idiopathic scoliosis with and without a subfascial wound drain: a multicentre randomized controlled trial. Bone & Joint Journal. 2022;104-B(9):1067–72. Doi: https://online.boneandjoint.org.uk/doi/10.1302/0301-620X.104B9.BJJ-2022-0391.R1

19. Ovadia D, Drexler M, Kramer M, Herman A, Lebel DE. Closed wound subfascial suction drainage in posterior fusion surgery for adolescent idiopathic scoliosis: a prospective randomized control study. Spine. 2019;44(6):377–83. Available from: https://journals.lww.com/00007632-201903150-00002

20. Kochai A, Erkorkmaz Ü. The role of drains in adolescent idiopathic scoliosis surgery: Is it necessary? Medicine 2019;98(51):e18061. Available from: https://journals.lww.com/10.1097/MD.0000000000018061

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Published

2026-04-13

How to Cite

Lampus, H., Candy, C., & Saumur, O. B. (2026). Effectiveness and Complications of Surgical Drainage in Pediatric Surgery: A Literature Review. Medical Scope Journal, 8(2), 268–276. https://doi.org/10.35790/msj.v8i2.65819

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