Yildirim Gulsah, Karakas Hakki
Department of Radiology, Istanbul Fatih Sultan Mehmet Training and Research Hospital, University of Health Sciences, Istanbul, Turkey.
Pol J Radiol. 2022 Apr 29;87:e238-e245. doi: 10.5114/pjr.2022.115815. eCollection 2022.
We have investigated the technical and clinical success of percutaneous catheter drainage (PCD) in retroperitoneal abscesses and factors that may affect the outcome.
The study cohort included 45 patients (17 females and 29 males, with mean age of 56.3 years) that were treated between 2012 and 2020. Forty-seven abscesses were managed with PCD under ultrasonography, computed tomography, or fluoroscopy guidance. Patients' demographics, lesion locations, predisposing factors, clini-cal presentation, etiology, radiological findings, technical factors, and outcome parameters were presented using exploratory and descriptive statistics.
Abscesses were located in the psoas ( = 25, 55.3%), renal-perirenal ( = 7, 14.8%), and pararenal ( = 14, 29.7%) compartments. The mean preprocedural volume was 263.3 (30-1310) ml. Pain (abdominal and back) (57.4%) and fever (17%) were the most frequent presenting symptoms. The most common predisposing factors were previous surgery ( = 17, 36.1%) and diabetes mellitus ( = 11, 25.5%). Clinical success was attained in 89.3% of abscesses (definitive treatment 72.3% and partial success 17.0%). There was a statistically significant difference between the iatrogenic and non-iatrogenic groups regarding clinical success ( = 0.031). No mortality was encountered. The complication rate was 6.6% and were all minor. The average rate of recurrence was 10.6%. The mean time to catheter removal was 15.8 ± 13.2 days.
PCD is a safe and effective procedure in the treatment of retroperitoneal abscesses. Procedure-related mortality, morbidity, and complication rates are low. Underlying etiology is a significant factor affecting the outcome. Nevertheless, PCD may provide definitive treatment in the majority of patients.
我们研究了经皮导管引流（PCD）治疗腹膜后脓肿的技术成功率和临床成功率以及可能影响治疗结果的因素。
研究队列包括2012年至2020年间接受治疗的45例患者（17例女性和29例男性，平均年龄56.3岁）。在超声、计算机断层扫描或荧光镜引导下，对47个脓肿进行了PCD治疗。使用探索性和描述性统计方法展示患者的人口统计学特征、病变位置、易感因素、临床表现、病因、影像学表现、技术因素和结果参数。
脓肿位于腰大肌（n = 25，55.3%）、肾周（n = 7，14.8%）和肾旁（n = 14，29.7%）间隙。术前平均脓肿体积为263.3（30 - 1310）ml。疼痛（腹部和背部）（57.4%）和发热（17%）是最常见的症状。最常见的易感因素是既往手术（n = 17，36.1%）和糖尿病（n = 11，25.5%）。89.3%的脓肿获得临床成功（根治性治疗72.3%，部分成功17.0%）。医源性组和非医源性组在临床成功率方面存在统计学显著差异（P = 0.031）。未发生死亡病例。并发症发生率为6.6%，均为轻微并发症。平均复发率为10.6%。导管拔除的平均时间为15.8 ± 13.2天。
PCD是治疗腹膜后脓肿的一种安全有效的方法。与手术相关的死亡率、发病率和并发症发生率较低。潜在病因是影响治疗结果的一个重要因素。然而，PCD可能为大多数患者提供根治性治疗。
