经腹膜后镜引流术治疗结核性腰椎脊柱炎合并复杂腰大肌脓肿。
Retroperitoneoscopic drainage of complicated psoas abscesses in patients with tuberculous lumbar spondylitis.
机构信息
Department of Orthopedic Surgery, Meram Faculty of Medicine, Selcuk University, Meram, Konya, Turkey.
出版信息
Eur Spine J. 2012 Mar;21(3):470-3. doi: 10.1007/s00586-011-2049-2. Epub 2011 Oct 21.
PURPOSE
Nowadays, endoscopic techniques are widely used in surgical procedures. Retroperitoneoscopy has been an extremely valuable tool for a wide variety of urologic disorders, whereas, it has limited use in orthopedic procedures.
METHODS
We performed retroperitoneoscopic drainage (in combination with medical treatment) of complicated psoas abscess on 12 patients with tuberculous spondylitis. All the procedures were done under general anesthesia and in the lateral decubitus position. Psoas abscess was evacuated during procedure, and postoperatively, drainage was continued through a large silastic tube. The definitive diagnosis and the treatment were made based on the results of culture-antibiogram and PCR testing.
RESULTS
Complete clinical and radiologic remission was observed in all patients in 3-6 months. The complication was not observed in any case postoperatively.
CONCLUSIONS
Retroperitoneoscopic drainage of psoas abscesses gains advantages in terms of rapid recovery, minimal invasiveness, absence of radiation, and shorter hospital stay. This procedure can be used not only for cold abscesses but also for other pathologies of lumbar vertebral area.
目的
如今，内镜技术在外科手术中得到了广泛应用。后腹腔镜技术对于治疗各种泌尿科疾病非常有价值，而对于骨科手术的应用则较为有限。
方法
我们对 12 例患有结核性脊柱炎的患者采用后腹腔镜引流（联合药物治疗）治疗复杂的腰大肌脓肿。所有手术均在全身麻醉和侧卧位下进行。手术过程中排空腰大肌脓肿，术后通过大的硅胶管继续引流。根据培养药敏试验和 PCR 检测结果做出明确诊断和治疗。
结果
所有患者在 3-6 个月内均完全临床和影像学缓解。术后无并发症发生。
结论
后腹腔镜引流腰大肌脓肿具有恢复快、微创、无辐射和住院时间短的优点。该手术不仅可用于冷脓肿，还可用于腰椎区域的其他病变。
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