Department of Gastroenterology, the Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan Province, China.
Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, the Affliated Hospital of Southwest Medical University, Luzhou, Sichuan Province, China.
Expert Rev Gastroenterol Hepatol. 2022 Oct;16(10):993-1002. doi: 10.1080/17474124.2022.2130247. Epub 2022 Oct 3.
As an emerging minimally invasive technology, endoscopic ultrasound (EUS) has been reported to treat pelvic abscess instead of surgical or image-guided percutaneous drainage (PCD) under certain conditions. The aim of this study was to assess the efficacy and safety of EUS-guided drainage for patients with pelvic abscesses.
We conducted a comprehensive literature search on PubMed, Embase, Cochrane Library, and Web of Science databases (inception-March 2022). The main outcomes were technical success, clinical success, and complications. Comprehensive meta-analysis software was used to calculate the pooled event rate.
Twelve studies containing 272 patients were included. These pelvic abscesses most frequently developed after abdominal and pelvic surgery (n = 180, 66.2%), inflammatory bowel disease (n = 32, 11.8%), and other inflammatory conditions. Respectively, the pooled technical and clinical success rate was 100% and 88.7% [95% confidence interval (CI): 83.8-92.2%, I = 1.0%, p < 0.001]. After excluding an individual study, the pooled rate of complications changed from 11.5% (95% CI: 7.4-17.4%, I = 38.8%, p < 0.001) to 8.2% (95% CI: 5.0-13.3%, I = 0, p < 0.001).
EUS-guided drainage of the pelvic abscess was feasible, effective, and safe. Further randomized-controlled studies with large-sample sizes were required in the future.
作为一种新兴的微创技术,内镜超声(EUS)已被报道可在某些情况下替代手术或影像引导经皮引流(PCD)治疗盆腔脓肿。本研究旨在评估 EUS 引导引流治疗盆腔脓肿患者的疗效和安全性。
我们对 PubMed、Embase、Cochrane 图书馆和 Web of Science 数据库(从创建到 2022 年 3 月)进行了全面的文献检索。主要结局为技术成功率、临床成功率和并发症。综合荟萃分析软件用于计算汇总事件率。
共纳入 12 项研究,包含 272 例患者。这些盆腔脓肿主要发生在腹部和盆腔手术后(n=180,66.2%)、炎症性肠病(n=32,11.8%)和其他炎症性疾病后。技术成功率和临床成功率分别为 100%和 88.7%[95%置信区间(CI):83.8-92.2%,I=1.0%,p<0.001]。排除个别研究后,并发症的汇总发生率从 11.5%(95%CI:7.4-17.4%,I=38.8%,p<0.001)变为 8.2%(95%CI:5.0-13.3%,I=0,p<0.001)。
EUS 引导下引流治疗盆腔脓肿是可行的、有效的且安全的。未来需要进一步开展大样本量的随机对照研究。