Hong Chang Hwa, Hong Yong Cheol, Bae Sang Ho, Son Myoung Won, Won Sung Hun, Ryu Aeli, Kim Chang Hyun, Chang Hee Jun, Kim Woo Jong
Department of Orthopaedic Surgery.
Department of Surgery, Soonchunhyang University Hospital Cheonan, Dongnam-gu, Cheonan.
Medicine (Baltimore). 2020 Apr;99(14):e19640. doi: 10.1097/MD.0000000000019640.
A psoas abscess is a rare but potentially devastating condition that is associated with risks of neurological deficits, septic shock, and even death. The current first-line treatment is percutaneous catheter drainage (PCD) under imaging guidance, combined with broad-spectrum antibiotics. Surgical drainage should be considered if PCD fails or is impossible.Although many studies on PCD and open surgical drainage have appeared, the outcomes of laparoscopic drainage have rarely been reported. Thus, we laparoscopically drained the psoas abscesses of 6 patients; drainage was complete and we encountered no recurrence or complication. All patients were evaluated by plain radiography, contrast-enhanced computed tomography, and laboratory tests; all were followed-up for 1 year. Laparoscopic drainage is a good treatment option when PCD fails, affording all the advantages of open surgery (complete drainage, resection of infected tissue, and contermporaneous treatment of concomitant lesions). Also, laparoscopic drainage is minimally invasive, requires a smaller incision, and allows rapid recovery.
腰大肌脓肿是一种罕见但可能具有毁灭性的疾病，与神经功能缺损、感染性休克甚至死亡风险相关。目前的一线治疗方法是在影像引导下进行经皮导管引流（PCD），并联合使用广谱抗生素。如果PCD失败或无法进行，则应考虑手术引流。尽管已经出现了许多关于PCD和开放手术引流的研究，但腹腔镜引流的结果很少被报道。因此，我们对6例患者的腰大肌脓肿进行了腹腔镜引流；引流彻底，未出现复发或并发症。所有患者均通过X线平片、增强CT和实验室检查进行评估；所有患者均随访1年。当PCD失败时，腹腔镜引流是一种很好的治疗选择，具有开放手术的所有优点（彻底引流、切除感染组织以及同时治疗伴发病变）。此外，腹腔镜引流微创，切口小，恢复快。
