Truong S, Willis S, Jansen M, Neuerburg J, Schumpelick V
Chirurgische Universitäts- und Poliklinik, RWTH Aachen.
Chirurg. 1997 Jun;68(6):633-7. doi: 10.1007/s001040050244.
Pelvic abscesses are severe complications after rectal surgery. In recent years, surgical drainage has been edged out by percutaneous drainage techniques. We report our experience with the drainage of postoperative pelvic abscesses via the paracoccygeal route controlled by endosonography. In eight patients the diagnosis of a retrorectal pelvic abscess was established by endosonography and confirmed by endosonographically controlled exploratory puncture. Drainage of the abscesses was performed via the paracoccygeal access route by trocar or Seldinger technique under permanent visual control by endoluminal sonography. Irrigation of the abscess cavity was than performed daily. In all cases drainage was successful without complications. Duration of drainage was 9-14 days with a mean of 10.8 days. In one patient there was a recurrence of the abscess because of early removal of the drainage catheter. Because of its overall availability and its good results, paracoccygeal percutaneous endosonographically controlled drainage seems to be a suitable uncomplicated method for drainage of postoperative pelvic abscesses.
盆腔脓肿是直肠手术后的严重并发症。近年来,手术引流已逐渐被经皮引流技术所取代。我们报告了经骶尾旁途径在腔内超声引导下引流术后盆腔脓肿的经验。8例患者经腔内超声诊断为直肠后盆腔脓肿,并经腔内超声引导下穿刺探查确诊。在腔内超声持续可视控制下,采用套管针或Seldinger技术经骶尾旁入路对脓肿进行引流。然后每天对脓肿腔进行冲洗。所有病例引流均成功,无并发症发生。引流持续时间为9 - 14天,平均10.8天。1例患者因引流导管过早拔除导致脓肿复发。由于其整体可用性和良好的效果,经骶尾旁经皮腔内超声引导下引流似乎是一种适用于术后盆腔脓肿引流的简单方法。