Dhindsa Banreet Singh, Naga Yassin, Saghir Syed Mohsin, Dhaliwal Amaninder, Ramai Daryl, Cross Chad, Singh Shailender, Bhat Ishfaq, Adler Douglas G
Division of Gastroenterology and Hepatology, University of Nebraska Medical Center, 982000 Nebraska Medical Center, Omaha, NE, USA.
Department of Internal Medicine, University of Nevada, Las Vegas School of Medicine, Las Vegas, NV, USA.
Endosc Ultrasound. 2021 May-Jun;10(3):185-190. doi: 10.4103/eus.eus_71_20.
EUS-guided pelvic abscess drainage (EUS-PAD) is a procedure that utilizes an echoendoscope to visualize an area of interest for needle insertion and placement of a stent, catheter, or both for drainage of the target abscess. The aim of this study was to perform a systematic review and meta-analysis for the safety and efficacy of EUS-PAD.
We conducted a comprehensive search of several databases and conference proceedings including PubMed, EMBASE, Google Scholar, MEDLINE, SCOPUS, and Web of Science databases (earliest inception to February 2020). The primary outcomes for this study were the technical and clinical success of EUS-PAD. The secondary outcomes assessed for this study were adverse events of the procedure and subgroup analysis of individual adverse events.
Eight studies with a total of 135 patients combined were included in our analysis. The rate of technical success was 100% and the calculated pooled rate of clinical success was 92% (95% confidence interval [CI]: 87%, 98%; P = 0.31; I = 15%). The calculated pooled rate of adverse events was 9.4% (±17.9%), with stent migration (5.5 ± 18.06%) being the most common adverse event.
EUS-PAD offers a viable alternative that can minimize the need for surgical intervention in the drainage of pelvic abscesses. EUS-PAD has also demonstrated long-term clinical success with an acceptable rate of complications.
超声内镜引导下盆腔脓肿引流术（EUS-PAD）是一种利用超声内镜可视化感兴趣区域，以便插入针并放置支架、导管或两者皆用，来引流目标脓肿的操作。本研究的目的是对EUS-PAD的安全性和有效性进行系统评价和荟萃分析。
我们对多个数据库和会议论文集进行了全面检索，包括PubMed、EMBASE、谷歌学术、MEDLINE、SCOPUS和Web of Science数据库（最早收录至2020年2月）。本研究的主要结局是EUS-PAD的技术成功和临床成功。本研究评估的次要结局是该操作的不良事件以及对个体不良事件的亚组分析。
我们的分析纳入了8项研究，共135例患者。技术成功率为100%，计算得出的临床成功合并率为92%（95%置信区间[CI]：87%，98%；P = 0.31；I² = 15%）。计算得出的不良事件合并率为9.4%（±17.9%），支架移位（5.5 ± 18.06%）是最常见的不良事件。
EUS-PAD提供了一种可行的替代方法，可将盆腔脓肿引流中手术干预的需求降至最低。EUS-PAD也已证明具有长期临床成功且并发症发生率可接受。
