Department of Radiology, Soonchunhyang University College of Medicine, Cheonan Hospital, Cheonan, Republic of Korea.
Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
J Vasc Interv Radiol. 2022 Dec;33(12):1500-1506. doi: 10.1016/j.jvir.2022.07.031. Epub 2022 Sep 7.
To investigate the feasibility and safety of a modified surgical drain-guided percutaneous catheter drainage technique for postoperative fluid collection in inaccessible locations.
The modified technique was used in 24 patients (age, 58.6 years ± 11.3; men, 58.3%) from September 2015 to March 2021. All fluid collections had no safe access route on preprocedural computed tomography (CT) images. Every patient had a long (>20 cm) and tortuous surgical drain, which prevented the use of conventional surgical drain exchange. A favorable midpoint of the surgical drain tract was punctured under either ultrasound or fluoroscopic guidance, and a guide wire was advanced into the fluid collection. Technical success was defined as the successful placement of a drainage catheter, and clinical success was defined as the complete evacuation of fluid collection without recurrence. Follow-up was performed using CT images and a chart review. Adverse events within 30 days of the procedure were evaluated.
Target fluid collections in the pelvic cavity (n = 9); subphrenic (n = 7), peripancreatic (n = 4), and subhepatic spaces (n = 3); and abdominal cavity (n = 1) were drained using catheters measuring 7-10.2 F in diameter and 25-30 cm in length. The technical success rate was 91.7% (22/24), and the clinical success rate was 90.9% (20/22). No procedure-related or catheter-related adverse events were observed. The median follow-up period was 8.2 months (range, 10-1,721 days).
The modified surgical drain-guided percutaneous catheter drainage technique is a useful alternative when conventional exchange techniques cannot be used because of long and tortuous surgical drain paths.
探讨改良的引流管引导经皮导管引流技术在治疗难以触及部位术后积液中的可行性和安全性。
2015 年 9 月至 2021 年 3 月，采用改良技术对 24 例（年龄 58.6 岁±11.3 岁；男性 58.3%）患者的积液进行引流。所有积液在术前 CT 图像上均无安全的进入路径。每位患者均有一条长（>20cm）且迂曲的引流管，这使得常规引流管更换无法进行。在超声或透视引导下，于引流管的适当中点处进行穿刺，并将导丝推进至积液部位。技术成功定义为成功放置引流导管，临床成功定义为积液完全排空且无复发。通过 CT 图像和病历回顾进行随访。评估术后 30 天内的不良事件。
共引流盆腔积液 9 例，膈下积液 7 例，胰周积液 4 例，肝下间隙积液 3 例，腹腔积液 1 例。使用直径 7-10.2F、长 25-30cm 的引流导管。技术成功率为 91.7%（22/24），临床成功率为 90.9%（20/22）。无与手术或导管相关的不良事件。中位随访时间为 8.2 个月（范围 10-1721 天）。
当由于引流管路径长且迂曲而无法使用常规交换技术时，改良的引流管引导经皮导管引流技术是一种有用的替代方法。
