University of Health Sciences, Kanuni Sultan Suleyman Training and Research Hospital, Department of Obstetrics and Gynecology; Istanbul, Türkiye.
University of Health Sciences Turkey, Sehit Prof. Dr. Ilhan Varank Sancaktepe Training and Research Hospital, Clinic of Obstetrics and Gynecology, Istanbul, Türkiye.
Ginekol Pol. 2024;95(5):350-355. doi: 10.5603/gpl.96824. Epub 2023 Dec 15.
Tubo-ovarian abscess (TOA) is inflammation of the pelvic organs, mainly originating from the lower genital tract and intestinal tract. Treatment options include antibiotic therapy, surgical drainage, and radiologically guided (interventional) drainage. In our study, we aimed to evaluate the treatment method to be chosen and thus to manage patients with tuba ovarian abscesses (TOAs) most accurately.
This is a retrospective cohort study, and patients who applied to a tertiary center diagnosed with tuba ovarian abscess (TOA) were included. TOA size (cm), pre-treatment C-reactive protein (CRP) value, pre-treatment white blood cell (WBC) value, previous operation type, postoperative complication, and antibiotics used were screened.
305 patients were included in the study, and medical treatment was applied to 140 patients, organ-sparing surgical drainage to 50 patients, and surgical treatment to 115 patients. TOA dimensions measured at the time of diagnosis were significantly lower in patients for whom only medical treatment was sufficient. Pre-treatment CRP levels, WBC levels, and length of stay were significantly lower in patients for whom only medical treatment was sufficient. There was no significant difference between the pre-and post-procedure CRP difference, antibiotics, and hospitalization time.
Preferring minimally invasive treatment in cases requiring invasive treatment reduces the frequency of complications. Treatment of tuba ovarian abscesses (TOA) with minimally invasive methods will be more beneficial in terms of patient morbidity.
输卵管卵巢脓肿(TOA)是盆腔器官的炎症,主要源于下生殖道和肠道。治疗方案包括抗生素治疗、手术引流和放射引导(介入)引流。在我们的研究中,我们旨在评估选择的治疗方法,从而最准确地管理输卵管卵巢脓肿(TOA)患者。
这是一项回顾性队列研究,纳入了向三级中心就诊、被诊断为输卵管卵巢脓肿(TOA)的患者。筛选 TOA 大小(cm)、治疗前 C 反应蛋白(CRP)值、治疗前白细胞(WBC)值、既往手术类型、术后并发症和使用的抗生素。
研究共纳入 305 例患者,140 例患者接受了药物治疗,50 例患者接受了保留器官的手术引流,115 例患者接受了手术治疗。仅接受药物治疗的患者的诊断时 TOA 尺寸明显较小。仅接受药物治疗的患者的治疗前 CRP 水平、WBC 水平和住院时间明显较低。CRP 差值、抗生素和住院时间的术前和术后无显著差异。
在需要侵入性治疗的情况下选择微创治疗可降低并发症发生率。采用微创方法治疗输卵管卵巢脓肿(TOA)将更有利于降低患者发病率。