ORIGINAL ARTICLE The use of intra-abdominal drain in minimally invasive right colectomy: a propensity score matched analysis on postoperative outcomes Leonardo Solaini 1,2 & Davide Cavaliere 1 & Francesca Pecchini 3 & Federico Perna 4 & Andrea Avanzolini 1 & Giulia Vitali 1 & Fouzia Mecheri 3 & Paolo Checcacci 4 & Alessandro Cucchetti 1,2 & Andrea Coratti 4 & Micaela Piccoli 3 & Giorgio Ercolani 1,2 Accepted: 18 October 2019 # Springer-Verlag GmbH Germany, part of Springer Nature 2019 Abstract Purpose No evidences supporting or not the use of intra-abdominal drain (AD) in minimally invasive right colectomies have been published. This study aims to assess the outcomes on its use after robotic or laparoscopic right colectomies. Methods This is a multicenter propensity score matched study including patients who underwent minimally invasive right colectomy with (AD group) or without (no-AD group) the use of AD between February 1, 2007, and January 31, 2018. AD patients were matched to no-AD patients in a 1:1 ratio. Main outcomes were postoperative morbidity and mortality and anastomotic leak. Results A total of 653 patients were included. Of 149 (22.8%) no-AD patients, 124 could be matched. The rate of postoperative complications (AD n = 26, 21% vs. no-AD n = 26, 21%; p = 1.000), mortality (AD n = 2, 1.6% vs. no-AD n = 1, 0.8%; p = 1.000), anastomotic leak (AD n = 2, 1.6% vs. no-AD n = 5, 4.0%; p = 0.453), and wound infection (AD n = 9, 7.3% vs. no-AD n = 6, 4.8%; p = 0.581) did not significantly differ between the groups. Time to oral feeding was significantly shorter in the no- AD group [2 (1–3) vs. 3 (2–3), p = 0.0001]. The median length of hospital stay was 8 (IQR 7–9) in the AD group while it was 6 (IQR 5–9) in the no-AD group (p = 0.010). Conclusions In conclusion, the use of AD after minimally invasive right colectomies has no influence on postoperative morbidity and mortality rates. Keywords Robotic surgery . Minimally invasive right colectomy . Laparoscopy . Outcomes . Drain . Drainage . ERAS Introduction Current Enhanced Recovery After Surgery (ERAS) guidelines do not recommend the use of intra-abdominal drain (AD) after right hemicolectomy [1, 2]. However, there is no recent liter- ature supporting (or not) the use of AD, and the majority of the published studies dealt with its use after colorectal anastomoses. Furthermore, no reports have evaluated the impact of the use of AD in the minimally invasive surgery era, as most of the papers on this topic were published more than 20 years ago [3–8]. As a possible consequence of this lack of evidence, current studies on AD after either robotic or laparoscop- ic right colectomies show that several surgeons still rou- tinely place the intra-abdominal drain during these pro- cedures [9–16]. With this paper, we aim to analyze a large series of mini- mally invasive right hemicolectomies to understand whether the use of the intraabdominal drain could be justified and whether its placement could affect the outcomes. * Leonardo Solaini leonardo.solaini2@unibo.it 1 General and Oncologic Surgery, Morgagni-Pierantoni Hospital, Ausl Romagna, Forlì, Italy 2 Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy 3 Division of General, Emergency Surgery and New Technologies, OCSAE (Ospedale Civile Sant’Agostino Estense), Baggiovara, Modena, Italy 4 Division of Oncological and Robotic General Surgery, Careggi University Hospital, Florence, Italy International Journal of Colorectal Disease https://doi.org/10.1007/s00384-019-03440-w