CT 引导下引流憩室脓肿的结果及与结肠相通瘘管的预测因素。

Outcomes after CT guided drainage of diverticular abscesses and predictive factors for fistulous communication to the colon.

机构信息

MercyOne Des Moines Medical Center, 1111 6th Ave., Des Moines, IA, 50314, USA.

MercyOne Des Moines Medical Center, 1111 6th Ave., Des Moines, IA, 50313, USA.

出版信息

Am J Surg. 2021 Jul;222(1):193-197. doi: 10.1016/j.amjsurg.2020.10.010. Epub 2020 Oct 9.

DOI:10.1016/j.amjsurg.2020.10.010

PMID:33059942

Abstract

BACKGROUND

The purpose of the study is to analyze patient outcomes following CT guided drainage of colonic diverticular abscesses and identify the factors associated with development of fistulous communication to the drain.

METHODS

All patients undergoing CT guided abscess drainage, from 2009 to 2017, were included in this single institutional study. Clinical and demographic variables associated with development of colonic fistula were investigated.

RESULTS

One-hundred-and-five patients (55% female), mean abscess size and BMI of 6.3 cm and 30.28 kg/m, respectively, underwent CT guided abscess drainage. Patients with fistula had longer operative times (p = 0.03). On multivariable analysis, females (p = 0.02) and higher BMI (p = 0.01) were protective against, while increasing size (p = 0.01) was predictive of developing fistulous communication to the drain.

CONCLUSION

More than half of patients developed colonic fistula after CT guided drainage. Male sex, lower BMI and increasing abscess size were predictive of developing colonic fistula.

摘要

背景

本研究旨在分析 CT 引导下结肠憩室脓肿引流后的患者结局，并确定与引流管发生瘘管沟通相关的因素。

方法

本单中心研究纳入了 2009 年至 2017 年间所有接受 CT 引导下脓肿引流的患者。研究调查了与结肠瘘发生相关的临床和人口统计学变量。

结果

105 名患者（55%为女性），脓肿大小和 BMI 的平均值分别为 6.3 厘米和 30.28 千克/平方米，接受 CT 引导下脓肿引流。发生瘘管的患者手术时间更长（p=0.03）。多变量分析显示，女性（p=0.02）和较高 BMI（p=0.01）可降低瘘管形成的风险，而脓肿大小增加（p=0.01）则可预测引流管发生瘘管沟通。