Departments of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan,
Surg Today. 2013 Oct;43(10):1095-102. doi: 10.1007/s00595-013-0504-x. Epub 2013 Feb 14.
To improve the selection of patients for percutaneous abscess drainage (PAD) to treat postoperative intra-abdominal abscess after gastrointestinal surgery, we investigated the factors predictive of outcome.
Of 143 consecutive patients with symptomatic postoperative intra-abdominal abscess after a gastrointestinal tract resection, 104 who underwent image-guided PAD as the initial treatment were reviewed. We assessed the possible associations between successful PAD and patient-, abscess-, surgical-, and drainage-related variables, and investigated the success rates of PAD for patients with vs. those without the factors related to successful outcome.
Based on monitoring for 1 year after PAD, the success rate of this procedure was 85.6% (89/104). Multivariate analysis revealed that the interval between surgery and the onset of abscess (p = 0.0234) and a single abscess (p = 0.0038) were independently associated with a successful outcome. Single late-onset abscess resolved completely within 10 weeks in 91.4% of these patients.
Despite new strategies aimed at preventing surgical site infection, PAD remains an important factor in the postoperative management of gastrointestinal surgery in Japan. Initial recognition of the day of onset and the number of abscesses are important prognostic factors.
为了提高经皮脓肿引流（PAD）治疗胃肠手术后腹腔内术后脓肿患者的选择，我们研究了预测结局的因素。
对 143 例因胃肠道切除术后出现症状性腹腔内脓肿而行影像学引导 PAD 初始治疗的连续患者进行回顾性研究。我们评估了 PAD 成功与患者、脓肿、手术和引流相关变量之间的可能关联，并研究了具有与不具有成功结局相关因素的患者的 PAD 成功率。
基于 PAD 后 1 年的监测，该手术的成功率为 85.6%（89/104）。多变量分析显示，手术与脓肿发病间隔（p=0.0234）和单个脓肿（p=0.0038）是与成功结局相关的独立因素。这些患者中，单一的迟发性脓肿在 10 周内完全消退的比例为 91.4%。
尽管有新的策略旨在预防手术部位感染，但 PAD 仍然是日本胃肠手术后管理的重要因素。早期识别发病日和脓肿数量是重要的预后因素。
