Intraperitoneal drain placement and outcomes after elective colorectal surgery: international matched, prospective, cohort study

Despite current guidelines, intraperitoneal drain placement after elective colorectal surgery remains widespread. Drains were not associated with earlier detection of intraperitoneal collections, but were associated with prolonged hospital stay and increased risk of surgical-site infections.Background Many surgeons routinely place intraperitoneal drains after elective colorectal surgery. However, enhanced recovery after surgery guidelines recommend against their routine use owing to a lack of clear clinical benefit. This study aimed to describe international variation in intraperitoneal drain placement and the safety of this practice. Methods COMPASS (COMPlicAted intra-abdominal collectionS after colorectal Surgery) was a prospective, international, cohort study which enrolled consecutive adults undergoing elective colorectal surgery (February to March 2020). The primary outcome was the rate of intraperitoneal drain placement. Secondary outcomes included: rate and time to diagnosis of postoperative intraperitoneal collections; rate of surgical site infections (SSIs); time to discharge; and 30-day major postoperative complications (Clavien-Dindo grade at least III). After propensity score matching, multivariable logistic regression and Cox proportional hazards regression were used to estimate the independent association of the secondary outcomes with drain placement. Results Overall, 1805 patients from 22 countries were included (798 women, 44.2 per cent; median age 67.0 years). The drain insertion rate was 51.9 per cent (937 patients). After matching, drains were not associated with reduced rates (odds ratio (OR) 1.33, 95 per cent c.i. 0.79 to 2.23; P = 0.287) or earlier detection (hazard ratio (HR) 0.87, 0.33 to 2.31; P = 0.780) of collections. Although not associated with worse major postoperative complications (OR 1.09, 0.68 to 1.75; P = 0.709), drains were associated with delayed hospital discharge (HR 0.58, 0.52 to 0.66; P < 0.001) and an increased risk of SSIs (OR 2.47, 1.50 to 4.05; P < 0.001). Conclusion Intraperitoneal drain placement after elective colorectal surgery is not associated with earlier detection of postoperative collections, but prolongs hospital stay and increases SSI risk

The science case of the FRS Ion Catcher for FAIR Phase-0

The FRS Ion Catcher at GSI enables precision experiments with thermalized projectile and fission fragments. At the same time it serves as a test facility for the Low-Energy Branch of the Super-FRS at FAIR. The FRS Ion Catcher has been commissioned and its performance has been characterized in five experiments with 238U and 124Xe projectile and fission fragments produced at energies in the range from 300 to 1000 MeV/u. High and almost element-independent efficiencies for the thermalization of short-lived nuclides produced at relativistic energies have been obtained. High-accuracy mass measurements of more than 30 projectile and fission fragments have been performed with a multiple-reflection time-of-flight mass spectrometer (MR-TOF-MS) at mass resolving powers of up to 410,000, with production cross sections down to the microbarn-level, and at rates down to a few ions per hour. The versatility of the MR-TOF-MS for isomer research has been demonstrated by the measurement of various isomers, determination of excitation energies and the production of a pure isomeric beam. Recently, several instrumental upgrades have been implemented at the FRS Ion Catcher. New experiments will be carried out during FAIR Phase-0 at GSI, including direct mass measurements of neutron-deficient nuclides below 100Sn and neutron-rich nuclides below 208Pb, measurement of β-delayed neutron emission probabilities and reaction studies with multi-nucleon transfer.Peer reviewe