Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, No. 305 East Zhongshan Road, Nanjing, 210002, China.
Int J Colorectal Dis. 2012 Feb;27(2):199-206. doi: 10.1007/s00384-011-1338-x. Epub 2011 Nov 4.
Percutaneous drainage (PD) of Crohn's related abscesses is becoming popular with the development of techniques. We retrospectively analyzed the outcome of initial PD versus initial surgical drainage for intra-abdominal abscesses in Crohn's disease.
Twenty-three patients of Crohn's disease complicated with intra-abdominal or pelvic abscesses treated in our institution between July 2001 and April 2010 were retrospectively identified from 188 patients with proven Crohn's disease. Outcome measures included abscess recurrence after different treatments, post-drainage complications, ultimate stoma creation, and subsequent surgery for Crohn's disease.
Patients were divided into initial PD group (n = 10) and initial surgery group (n = 13): post-drainage complications were more common in initial surgery group (2/10 vs 9/13, P = 0.036), abscess recurred in three patients (2/10 vs 1/13, NS), and subsequent surgery was needed in 10 patients (6/10 vs 4/13, NS). Ultimate stoma creation were significantly more in initial surgery group (1/10 vs 9/13, P = 0.01).
Initial PD group had lower rate of post-drainage complications and ultimate stoma creation compared to the initial surgery group. Although subsequent surgery may not be avoided after PD, it can provide safe anastomosis for resections. Long-term follow-up should be done to assess the outcome of PD.
随着技术的发展，经皮引流（PD）在治疗克罗恩病相关脓肿方面越来越受欢迎。我们回顾性分析了初始 PD 与初始手术引流治疗克罗恩病腹腔内脓肿的结果。
我们从 188 例确诊的克罗恩病患者中回顾性地确定了 2001 年 7 月至 2010 年 4 月期间在我院治疗的 23 例并发腹腔或盆腔脓肿的克罗恩病患者。观察指标包括不同治疗后脓肿复发、引流后并发症、最终造口术以及克罗恩病的后续手术。
患者分为初始 PD 组（n=10）和初始手术组（n=13）：初始手术组的引流后并发症更常见（2/10 比 9/13，P=0.036），3 例患者脓肿复发（2/10 比 1/13，NS），10 例患者需要后续手术（6/10 比 4/13，NS）。初始手术组最终造口术明显更多（1/10 比 9/13，P=0.01）。
与初始手术组相比，初始 PD 组的引流后并发症和最终造口术发生率较低。虽然 PD 后可能仍需要进行后续手术，但它可以为切除术提供安全的吻合。应进行长期随访以评估 PD 的结果。
