What do systematic reviews say?

Drain vs No drain

Drains showed no clear difference in mortality compared with no drains (low certainty).

• External drains versus no drains after burr‐hole evacuation for the treatment of chronic subdural haematoma in adults 2016 · Cochrane Headline outcomes only
  RR 0.78 [0.45, 1.33]
  5 studies · 539 participants
  Low

Drain vs No drain

It is very uncertain whether drain changes 30‐day mortality Death during the compared with no drain (very low certainty).

• Abdominal drainage versus no drainage post‐gastrectomy for gastric cancer 2015 · Cochrane Headline outcomes only
  RR 1.73 [0.38, 7.84]
  4 studies · 438 participants
  Very low

Drainage vs no drainage after open appendectomy

Drainage may leads to higher mortality compared with no drainage after open appendectomy (low certainty).

• Abdominal drainage to prevent intra‐peritoneal abscess after appendectomy for complicated appendicitis 2021 · Cochrane Headline outcomes only
  Peto OR 4.88 [1.18, 20.09]
  4 studies · 363 participants
  Low

Drain use vs No drain

Drain use showed no clear difference in mortality compared with no drain use following pancreatic surgery (low certainty).

• Prophylactic abdominal drainage for pancreatic surgery 2021 · Cochrane Headline outcomes only
  RR 0.78 [0.31, 1.99]
  4 studies · 1055 participants
  Low
• Prophylactic abdominal drainage for pancreatic surgery 2021 · Cochrane Headline outcomes only
  RR 0.23 [0.06, 0.9]
  2 studies · 478 participants
  Low

Active drain vs passive drain

It is very uncertain whether active drain changes mortality compared with passive drain following pancreatic surgery (very low certainty).

• Prophylactic abdominal drainage for pancreatic surgery 2021 · Cochrane Headline outcomes only
  RR 1.23 [0.3, 5.06]
  2 studies · 382 participants
  Very low
• Prophylactic abdominal drainage for pancreatic surgery 2021 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Routine abdominal drain vs No drain

It is very uncertain whether routine abdominal drain changes mortality compared with 'no drain' (very low certainty).

• Routine abdominal drainage versus no abdominal drainage for uncomplicated laparoscopic cholecystectomy 2013 · Cochrane Headline outcomes only
  RR 0.41 [0.04, 4.37]
  10 studies · 1681 participants
  Very low

Intra‐abdominal drainage vs no drainage after pelvic lymphadenectomy

Intra‐abdominal drainage showed no clear difference in mortality compared with no drainage (low certainty).

• Intra‐abdominal drains for the prophylaxis of anastomotic leak in elective colorectal surgery 2004 · Cochrane Headline outcomes only
  RR 0.77 [0.41, 1.45]
  3 studies · 908 participants
  Low

Pre‐operative biliary drainage vs direct surgery

It is very uncertain whether pre‐operative biliary drainage changes mortality compared with direct surgery (very low certainty).

• Pre‐operative biliary drainage for obstructive jaundice 2012 · Cochrane Headline outcomes only
  RR 1.12 [0.73, 1.71]
  6 studies · 520 participants
  Very low

T‐tube drainage vs primary closure

It is very uncertain whether T‐tube drainage changes peri‐operative mortality compared with primary closure (very low certainty).

• T‐tube drainage versus primary closure after open common bile duct exploration 2013 · Cochrane Headline outcomes only
  RR 2.25 [0.55, 9.25]
  6 studies · 359 participants
  Very low

Early vs late drain removal following pancreatic surgery

It is very uncertain whether early changes mortality compared with late drain removal following pancreatic surgery (very low certainty).

• Prophylactic abdominal drainage for pancreatic surgery 2021 · Cochrane Headline outcomes only
  RR 0.99 [0.06, 15.45]
  3 studies · 399 participants
  Very low
• Prophylactic abdominal drainage for pancreatic surgery 2021 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Open thoracotomy vs thoracostomy drainage

• Surgical versus non‐surgical management for pleural empyema 2017 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 30 participants
  Moderate

VATS vs thoracostomy drainage

VATS showed no clear difference in mortality compared with thoracostomy drainage (low certainty).

• Surgical versus non‐surgical management for pleural empyema 2017 · Cochrane Headline outcomes only
  OR 0.8 [0.04, 14.89]
  7 studies · 361 participants
  Low

Needle aspiration (needle removed immediately after aspiration) vs intercostal tube drainage

It is very uncertain whether needle aspiration (needle removed immediately after aspiration) changes mortality during hospitalisation compared with intercostal tube drainage (very low certainty).

• Needle aspiration versus intercostal tube drainage for pneumothorax in the newborn 2019 · Cochrane Headline outcomes only
  RR 3.92 [0.88, 17.58]
  1 study · 70 participants
  Very low

Needle aspiration (needle or angiocatheter left in situ) vs intercostal tube drainage

It is very uncertain whether needle aspiration (needle or angiocatheter left in situ) changes mortality during hospitalisation compared with intercostal tube drainage (very low certainty).

• Needle aspiration versus intercostal tube drainage for pneumothorax in the newborn 2019 · Cochrane Headline outcomes only
  RR 1.5 [0.27, 8.45]
  1 study · 72 participants
  Very low

Needle aspiration (needle removed immediately after aspiration) vs intercostal tube drainage

The review found no eligible studies for this question.

• Needle aspiration versus intercostal tube drainage for pneumothorax in the newborn 2019 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Needle aspiration (needle or angiocatheter left in situ) vs intercostal tube drainage

The review found no eligible studies for this question.

• Needle aspiration versus intercostal tube drainage for pneumothorax in the newborn 2019 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

VATS vs thoracostomy drainage

VATS showed no clear difference in mortality: adults compared with thoracostomy drainage (moderate certainty).

• Surgical versus non‐surgical management for pleural empyema 2017 · Cochrane Headline outcomes only
  OR 0.8 [0.04, 14.89]
  2 studies · 90 participants
  Moderate

VATS vs thoracostomy drainage

• Surgical versus non‐surgical management for pleural empyema 2017 · Cochrane Headline outcomes only
  no estimate extracted
  5 studies · 271 participants
  Moderate

Returning vs discarding gastric residuals

The review found no eligible studies for this question.

• Monitoring of gastric residual volume during enteral nutrition 2021 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found