To evealuate the impact of postoperative drain placement on the perioperative safety outcomes in patients undergoing carotid endarterectomy (CEA).

We retrospectively analyzed 141 CEA procedures performed at the Neurosurgery Department of Beijing Hospital between February 2019 and February 2024. The patients were categorized into two group: the non-drainage group and the drainage group, based on the use of a drain. Outcomes were compared between the two groups, including the duration of postoperative hospitalization, incidence of postoperative hematoma, frequency of hematomas requiring surgical intervention, perioperative mortality, and the occurrence of wound infection, acute myocardial infarction, surgery-related stroke, cranial nerve impairment, and cerebral hemorrhage associated with the surgery. T-test and chi-square were performed.

In the non-drainage group, 66 patients underwent CEA surgery 73 times. In the drainage group, 66 patients underwent CEA surgery 68 times.The analysis revealed no marked variance between the groups in terms of postoperatively drain placement and the incidence of postoperative hematoma, the rate of hematomas requiring further surgical measures, perioperative mortality, or any other complications (all P>0.05). However, the duration of postoperative hospital stay showed a statistically significant decrease in the group without drain placement compared to their counterparts [(4.48±2.49) d vs (5.67±3.42)d, t=-2.272, P=0.025].

The incidence of perioperative complications following CEA was not significantly different between the patients who received drain placement and those who did not. Furthermore, the absence of drain placement was associated with a shorter hospital stay duration.