Abstract：
OBJECTIVE: This is a retrospective study to evaluate the safety and efficacy of endoscopic ultrasound-guided pelvic abscess drainage (EUS-PAD) in a single hospital setting.
METHODS: The referral criteria for EUS-PAD included patients with a pelvic abscess (PA) that was amenable for the procedure. A total of 14 patients with PA treated with EUS-PAD were included in this study. The mean patient age was 57.4 years, and male-to-female ratio was 7:7. Overall, there were six cases of appendiceal perforation, five of rectal cancer and one case each of the diverticular perforation, perianal abscess, and walled-off necrosis.
RESULTS: Overall, 100% of procedures were successful. Clinical success was achieved in 11 patients and they were discharged after EUS-PAD within 21.4 days on an average and the average duration of stent placement before removal was 27.0 days. Of all, six patients achieved complete improvement status where the cause was appendiceal perforation while two and one of the patients were recovered where the causes were post-curative operation for carcinoma and walled-off necrosis, respectively. Eight out of eleven patients who exhibited appendiceal perforation or underwent radical rectal cancer surgery were discharged after an average of 9.4 days post EUS-PAD. Although two patients showed temporary improvement, with perianal abscess and controlled rectal carcinoma, the PA worsened as the primary disease intensified. The PA drainage was ineffective in three patients where two of them had uncontrolled rectal cancer and one had diverticular perforation.
CONCLUSIONS: Conclusively, the EUS-PAD is not only a reliable, safe, and efficient alternative to surgical and percutaneous drainage but also a valuable procedure with a high success rate for patients with acute infections, such as those who have had an appendiceal perforation or curative surgery. Poor indications and contraindications for EUS-PAD include uncontrolled gastrointestinal perforation and direct tumor invasion.
METHODS: The referral criteria for EUS-PAD included patients with a pelvic abscess (PA) that was amenable for the procedure. A total of 14 patients with PA treated with EUS-PAD were included in this study. The mean patient age was 57.4 years, and male-to-female ratio was 7:7. Overall, there were six cases of appendiceal perforation, five of rectal cancer and one case each of the diverticular perforation, perianal abscess, and walled-off necrosis.
RESULTS: Overall, 100% of procedures were successful. Clinical success was achieved in 11 patients and they were discharged after EUS-PAD within 21.4 days on an average and the average duration of stent placement before removal was 27.0 days. Of all, six patients achieved complete improvement status where the cause was appendiceal perforation while two and one of the patients were recovered where the causes were post-curative operation for carcinoma and walled-off necrosis, respectively. Eight out of eleven patients who exhibited appendiceal perforation or underwent radical rectal cancer surgery were discharged after an average of 9.4 days post EUS-PAD. Although two patients showed temporary improvement, with perianal abscess and controlled rectal carcinoma, the PA worsened as the primary disease intensified. The PA drainage was ineffective in three patients where two of them had uncontrolled rectal cancer and one had diverticular perforation.
CONCLUSIONS: Conclusively, the EUS-PAD is not only a reliable, safe, and efficient alternative to surgical and percutaneous drainage but also a valuable procedure with a high success rate for patients with acute infections, such as those who have had an appendiceal perforation or curative surgery. Poor indications and contraindications for EUS-PAD include uncontrolled gastrointestinal perforation and direct tumor invasion.
摘要：
目的：这是一项回顾性研究，旨在评估内镜超声引导盆腔脓肿引流术（EUS-PAD）在单一医院环境中的安全性和有效性。
方法：EUS-PAD的转诊标准包括适合手术的盆腔脓肿（PA）患者。本研究包括总共14例用EUS-PAD治疗的PA患者。患者平均年龄为57.4岁,男女比例为7:7。总的来说,有6例阑尾穿孔，5例直肠癌和1例憩室穿孔,肛周脓肿,和壁壁坏死。
结果：总体而言，100%的程序是成功的。在11例患者中取得了临床成功，他们在EUS-PAD后平均在21.4天内出院，并且在移除前放置支架的平均持续时间为27.0天。其中,6例患者达到完全改善状态，原因是阑尾穿孔，而2例和1例患者康复，原因是癌症和壁坏死的治疗后手术，分别。11例阑尾穿孔或接受直肠癌根治术的患者中有8例在EUS-PAD后平均9.4天后出院。尽管两名患者表现出暂时的改善，肛周脓肿和控制直肠癌，随着原发疾病的加剧，PA恶化。PA引流在三名患者中无效，其中两名患有不受控制的直肠癌，一名患有憩室穿孔。
结论：最后，EUS-PAD不仅是一个可靠的，安全,和有效的替代手术和经皮引流，但对急性感染患者来说也是一个有价值的手术，成功率很高，例如那些有阑尾穿孔或治愈性手术的人。EUS-PAD的不良适应症和禁忌症包括不受控制的胃肠道穿孔和直接肿瘤侵袭。
方法：EUS-PAD的转诊标准包括适合手术的盆腔脓肿（PA）患者。本研究包括总共14例用EUS-PAD治疗的PA患者。患者平均年龄为57.4岁,男女比例为7:7。总的来说,有6例阑尾穿孔，5例直肠癌和1例憩室穿孔,肛周脓肿,和壁壁坏死。
结果：总体而言，100%的程序是成功的。在11例患者中取得了临床成功，他们在EUS-PAD后平均在21.4天内出院，并且在移除前放置支架的平均持续时间为27.0天。其中,6例患者达到完全改善状态，原因是阑尾穿孔，而2例和1例患者康复，原因是癌症和壁坏死的治疗后手术，分别。11例阑尾穿孔或接受直肠癌根治术的患者中有8例在EUS-PAD后平均9.4天后出院。尽管两名患者表现出暂时的改善，肛周脓肿和控制直肠癌，随着原发疾病的加剧，PA恶化。PA引流在三名患者中无效，其中两名患有不受控制的直肠癌，一名患有憩室穿孔。
结论：最后，EUS-PAD不仅是一个可靠的，安全,和有效的替代手术和经皮引流，但对急性感染患者来说也是一个有价值的手术，成功率很高，例如那些有阑尾穿孔或治愈性手术的人。EUS-PAD的不良适应症和禁忌症包括不受控制的胃肠道穿孔和直接肿瘤侵袭。
