Ho Kim Seung, Hyup Kim Seung, Han Heon, Soo Kim Sam, Yeon Lee Ji, Hwan Jeon Yong
Department of Radiology, Seoul National University College of Medicine, Seoul, Korea.
Acta Radiol. 2008 Jul;49(6):718-23. doi: 10.1080/02841850802065026.
Transvaginal drainage using the trocar method is advantageous as a single-step procedure; however, the procedure may occasionally be difficult to perform, due to buckling of the catheter in the elastic vaginal tissues, despite the presence of a stiff stylet.
To evaluate the efficacy and the safety of image-guided transvaginal drainage of pelvic abscesses and fluid collection using a modified Seldinger technique.
Fifteen patients (mean age 43 years, range 24-82 years) who underwent transvaginal aspiration (n=1) or catheter drainage (n=14) guided by ultrasound and fluoroscopy were enrolled in this retrospective study. A small coronal incision was performed to facilitate puncture using an 18G needle, tract dilatation, and the insertion of a drainage catheter by the Seldinger technique. Outcome was analyzed with respect to clinical success, technical success, and procedure-related complications.
The overall clinical success rate was 87% (13/15 cases). The success rate of catheter drainage was 86% (12/14 cases), and the use of aspiration alone was successful in one patient. Technical success was achieved in all patients, without procedure-related complications.
Image-guided transvaginal drainage with a modified Seldinger technique can be a safe and effective alternative treatment for pelvic abscesses and fluid collection.
使用套管针方法进行经阴道引流作为一种单步操作具有优势；然而，尽管有硬导丝存在，但由于导管在弹性阴道组织中弯曲，该操作偶尔可能难以实施。
评估使用改良Seldinger技术在影像引导下经阴道引流盆腔脓肿和积液的有效性和安全性。
本回顾性研究纳入了15例患者（平均年龄43岁，范围24 - 82岁），这些患者接受了超声和荧光透视引导下的经阴道穿刺抽吸（n = 1）或导管引流（n = 14）。做一个小的冠状切口以便于使用18G针进行穿刺、扩张通道并通过Seldinger技术插入引流导管。分析临床成功率、技术成功率和与操作相关的并发症等结果。
总体临床成功率为87%（13/15例）。导管引流成功率为86%（12/14例），仅穿刺抽吸在1例患者中成功。所有患者均实现技术成功，且无与操作相关的并发症。
使用改良Seldinger技术在影像引导下经阴道引流可作为盆腔脓肿和积液的一种安全有效的替代治疗方法。
