000162104 001__ 162104
000162104 005__ 20251017144606.0
000162104 0247_ $$2doi$$a10.1097/JS9.0000000000002965
000162104 0248_ $$2sideral$$a144729
000162104 037__ $$aART-2025-144729
000162104 041__ $$aeng
000162104 100__ $$aBlanco, Francisco J.
000162104 245__ $$aPropensity score-matched analysis comparing drains and no-drains in rectal cancer surgery: the value of using a hemostatic agent instead. A prospective observational study
000162104 260__ $$c2025
000162104 5060_ $$aAccess copy available to the general public$$fUnrestricted
000162104 5203_ $$aBackground: This study evaluates the efficacy of Microporous Polysaccharide Hemospheres (MPH) as an alternative to prophylactic drains in rectal cancer surgery. We hypothesize that MPH reduces postoperative complications by minimizing fluid accumulation and associated risks, thereby improving outcomes within enhanced recovery protocols (ERP).
Methods: A prospective, multicenter observational study was conducted from January 2020 to January 2024, including adult patients undergoing high or low rectal resection for rectal cancer. Patients receiving MPH were compared to matched controls from the IMPRICA database who either received prophylactic drains or no drainage. Propensity score matching was employed to mitigate selection bias. Outcomes were assessed within the 30 postoperative days, focusing on surgical and medical complications.
Results: From a cohort of 3,725 patients, 90 received MPH without drainage, 2,806 underwent surgery with prophylactic drains, and 829 had no drains. Between 2020 and 2024, surgical complications were significantly lower in the MPH group (12.2%) compared to the drain group (26.2%) and comparable to the no-drain group (20.6%). The odds of complications in the MPH group were reduced by nearly half respect to the no-drain group (OR: 0.54 [95% CI: 0.27–1.08]). MPH was associated with fewer anastomotic leaks, hemorrhages, and surgical site infections, and no adverse effects were reported.
Conclusion: This study provides evidence that prophylactic drains are not only unnecessary but may also be potentially harmful in rectal surgery. The application of MPH offers a safe and effective alternative to improve postoperative outcomes. These findings support a shift toward eliminating drains in favor of innovative solutions aligned with ERP principles.
000162104 540__ $$9info:eu-repo/semantics/openAccess$$aby-nc-nd$$uhttps://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
000162104 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/acceptedVersion
000162104 700__ $$0(orcid)0000-0003-3859-0248$$aCastillo, Jorge$$uUniversidad de Zaragoza
000162104 700__ $$aMariner, Sergio
000162104 700__ $$aReig, Mónica
000162104 700__ $$aRobles, Jose A.
000162104 700__ $$aGuadalajara, Héctor
000162104 700__ $$aLeón-Arellano, Miguel
000162104 700__ $$aRuiz de la Hermosa, Alicia
000162104 700__ $$aFuenmayor, Maria L.
000162104 700__ $$aArroyo, Antonio
000162104 700__ $$aSánchez-Guillen, Luis
000162104 700__ $$0(orcid)0000-0003-0822-6904$$aDuque, María V.
000162104 700__ $$aGarcía-Coret, María J.
000162104 700__ $$aBaez, Celia
000162104 700__ $$aViñas, Xavier
000162104 700__ $$aAurensanz, Adrián$$uUniversidad de Zaragoza
000162104 700__ $$0(orcid)0000-0003-2461-8588$$aGracia, Zeus$$uUniversidad de Zaragoza
000162104 700__ $$0(orcid)0000-0002-0174-789X$$aAsín, Jesús$$uUniversidad de Zaragoza
000162104 700__ $$aBona, Alejandro
000162104 700__ $$0(orcid)0000-0001-7964-1166$$aRamirez, Jose M.$$uUniversidad de Zaragoza
000162104 7102_ $$12007$$2265$$aUniversidad de Zaragoza$$bDpto. Métodos Estadísticos$$cÁrea Estadís. Investig. Opera.
000162104 7102_ $$11013$$2090$$aUniversidad de Zaragoza$$bDpto. Cirugía$$cÁrea Cirugía
000162104 773__ $$g(2025), [18 pp.]$$pInt. j. surg.$$tInternational Journal of Surgery$$x1743-9191
000162104 8564_ $$s693200$$uhttps://zaguan.unizar.es/record/162104/files/texto_completo.pdf$$yPostprint
000162104 8564_ $$s1858478$$uhttps://zaguan.unizar.es/record/162104/files/texto_completo.jpg?subformat=icon$$xicon$$yPostprint
000162104 909CO $$ooai:zaguan.unizar.es:162104$$particulos$$pdriver
000162104 951__ $$a2025-10-17-14:15:23
000162104 980__ $$aARTICLE