Zhao Ning, Li Qian, Cui Jing, Yang Zhiyong, Peng Tao
Department of Gastrointestinal Surgery.
Department of Radiology.
Medicine (Baltimore). 2018 Oct;97(42):e12905. doi: 10.1097/MD.0000000000012905.
To explore the safety and efficacy of several special approaches of drainage for deep inaccessible intraabdominal and pelvic abscesses.
By searching of our institutional database, the clinical and radiologic information of all patients with special approaches of abscesses drainage was collected, consisting of etiology, diameter of abscess, duration of drainage, major complications, rates of success, failure and death, and pre-procedure, intra-procedure and post-procedure computed tomography scans.
A total of 124 patients are eligible for the criterion in our center between January 2010 and January 2018. The mean diameter of abscess was 5.6 cm (range 3.0-9.8 cm) and mean duration of drainage was 10.3 days (range 4-43 days). Pain was complained in 6 patients (4.8%) and hemorrhage was observed in one patient. Complete resolution of the abscess following drainage was observed in 115 patients (92.7%). A total of 9 patients (7.3%) failed to percutaneous abscess drainage and 3 patients died of catheter-unrelated diseases. Transintestinal afferent loop of drainage was firstly attempted in six patients and complete resolution of abscess was achieved in five patients.
Special approaches, including transgluteal, presacral space, transhepatic, multiplane reconstruction (MPR)-assisted oblique approach and transintestinal afferent loop approach for those deep inaccessible intraabdominal and pelvic abscesses are safe and feasible.
探讨几种特殊的深部腹腔及盆腔难以触及脓肿引流方法的安全性和有效性。
通过检索本机构数据库,收集所有采用特殊脓肿引流方法患者的临床和影像学信息,包括病因、脓肿直径、引流持续时间、主要并发症、成功、失败及死亡发生率,以及术前、术中和术后的计算机断层扫描。
2010年1月至2018年1月期间,本中心共有124例患者符合纳入标准。脓肿平均直径为5.6厘米(范围3.0 - 9.8厘米),平均引流持续时间为10.3天(范围4 - 43天)。6例患者(4.8%)主诉疼痛,1例患者出现出血。115例患者(92.7%)引流后脓肿完全消退。共有9例患者(7.3%)经皮脓肿引流失败,3例患者死于与导管无关的疾病。6例患者首次尝试经肠输入袢引流,5例患者脓肿完全消退。
对于深部腹腔及盆腔难以触及的脓肿,包括经臀、骶前间隙、经肝、多平面重建(MPR)辅助斜行入路及经肠输入袢入路等特殊方法是安全可行的。