PDF(Pubmed)
Abstract：
UNASSIGNED: EUS is a potential alternative for the drainage of abscesses. The aim of this study was to determine if EUS-guided pelvic abscess drainage is technically feasible, safe, and a valid option for abscess resolution.
UNASSIGNED: We conducted a retrospective review from 2002 to 2020 at a single quaternary institution. EUS-guided pelvic abscess drainage via the transrectal route was performed in all patients with or without drain/stent placement. Technical and clinical success of EUS-guided pelvic abscess drainage was analyzed. Descriptive analyses and Fisher exact test were performed.
UNASSIGNED: Sixty consecutive patients were included in the study (53.5% male; mean age, 53.8 ± 17.9 years). Pelvic abscesses occurred mainly postoperatively (33 cases; 60.0%) and from complicated diverticulitis (14 cases; 23.3%). Mean diameter was 6.5 ± 2.4 cm (80% unilocular). Drainage was performed with EUS-guided stent placement (double-pigtail plastic or lumen-apposing metal) in 74.5% of cases and with aspiration alone for the remainder. Technical success occurred in 58 cases (97%). Of those with long-term follow-up after EUS-guided pelvic abscess drainage (n = 55; 91.7%), complete abscess resolution occurred in 72.7% of all cases. Recurrence occurred in 8 cases (14.5%) and persisted in 7 patients (12.5%), 7 of which were successfully retreated with EUS-guided pelvic abscess drainage. Accounting for these successful reinterventions, the overall rate of abscess resolution was 85.5%. Abscess resolution rate improved with drain placement (83%). Accounting for 7 repeat EUS-guided pelvic abscess drainages, overall abscess resolution improved. Two deaths occurred (3.4%) because of sepsis from failed source control in patients who had previously failed medical, radiological, and surgical treatment.
UNASSIGNED: EUS-guided pelvic abscess drainage is technically feasible, safe, and an effective alternative to radiological or open surgical drainage. It also offers favorable clinical outcomes in different clinical situations.
UNASSIGNED: We conducted a retrospective review from 2002 to 2020 at a single quaternary institution. EUS-guided pelvic abscess drainage via the transrectal route was performed in all patients with or without drain/stent placement. Technical and clinical success of EUS-guided pelvic abscess drainage was analyzed. Descriptive analyses and Fisher exact test were performed.
UNASSIGNED: Sixty consecutive patients were included in the study (53.5% male; mean age, 53.8 ± 17.9 years). Pelvic abscesses occurred mainly postoperatively (33 cases; 60.0%) and from complicated diverticulitis (14 cases; 23.3%). Mean diameter was 6.5 ± 2.4 cm (80% unilocular). Drainage was performed with EUS-guided stent placement (double-pigtail plastic or lumen-apposing metal) in 74.5% of cases and with aspiration alone for the remainder. Technical success occurred in 58 cases (97%). Of those with long-term follow-up after EUS-guided pelvic abscess drainage (n = 55; 91.7%), complete abscess resolution occurred in 72.7% of all cases. Recurrence occurred in 8 cases (14.5%) and persisted in 7 patients (12.5%), 7 of which were successfully retreated with EUS-guided pelvic abscess drainage. Accounting for these successful reinterventions, the overall rate of abscess resolution was 85.5%. Abscess resolution rate improved with drain placement (83%). Accounting for 7 repeat EUS-guided pelvic abscess drainages, overall abscess resolution improved. Two deaths occurred (3.4%) because of sepsis from failed source control in patients who had previously failed medical, radiological, and surgical treatment.
UNASSIGNED: EUS-guided pelvic abscess drainage is technically feasible, safe, and an effective alternative to radiological or open surgical drainage. It also offers favorable clinical outcomes in different clinical situations.
摘要：
■EUS是脓肿引流的潜在替代方法。这项研究的目的是确定EUS引导的盆腔脓肿引流术在技术上是否可行，安全,和脓肿解决的有效选项。
■我们从2002年到2020年在一个单一的第四纪机构进行了回顾性审查。所有有或没有引流/支架放置的患者均通过经直肠途径进行EUS引导的盆腔脓肿引流。分析EUS引导盆腔脓肿引流术的技术和临床成功。进行描述性分析和Fisher精确检验。
■研究中纳入了60例连续患者(53.5%男性；平均年龄，53.8±17.9年）。盆腔脓肿主要发生于术后（33例；60.0％）和复杂性憩室炎（14例；23.3％）。平均直径为6.5±2.4cm(80%单眼)。74.5％的病例采用EUS引导的支架放置（双尾纤维塑料或内腔贴壁金属）进行引流，其余病例仅进行抽吸。58例（97%）技术成功。在EUS引导盆腔脓肿引流术后长期随访的患者中（n=55;91.7％），所有病例的72.7%出现脓肿完全消退.复发8例（14.5%），持续7例（12.5%），其中7例采用EUS引导盆腔脓肿引流术治疗成功。考虑到这些成功的再干预，脓肿总消退率为85.5%.脓肿分辨率随引流管放置而提高（83％）。占7次重复EUS引导盆腔脓肿引流，整体脓肿分辨率改善。发生2例死亡（3.4％），原因是先前医疗失败的患者因感染源控制失败而导致败血症，放射学,和手术治疗。
■EUS引导盆腔脓肿引流术在技术上是可行的，安全,以及放射或开放式手术引流的有效替代方法。它还在不同的临床情况下提供有利的临床结果。
■我们从2002年到2020年在一个单一的第四纪机构进行了回顾性审查。所有有或没有引流/支架放置的患者均通过经直肠途径进行EUS引导的盆腔脓肿引流。分析EUS引导盆腔脓肿引流术的技术和临床成功。进行描述性分析和Fisher精确检验。
■研究中纳入了60例连续患者(53.5%男性；平均年龄，53.8±17.9年）。盆腔脓肿主要发生于术后（33例；60.0％）和复杂性憩室炎（14例；23.3％）。平均直径为6.5±2.4cm(80%单眼)。74.5％的病例采用EUS引导的支架放置（双尾纤维塑料或内腔贴壁金属）进行引流，其余病例仅进行抽吸。58例（97%）技术成功。在EUS引导盆腔脓肿引流术后长期随访的患者中（n=55;91.7％），所有病例的72.7%出现脓肿完全消退.复发8例（14.5%），持续7例（12.5%），其中7例采用EUS引导盆腔脓肿引流术治疗成功。考虑到这些成功的再干预，脓肿总消退率为85.5%.脓肿分辨率随引流管放置而提高（83％）。占7次重复EUS引导盆腔脓肿引流，整体脓肿分辨率改善。发生2例死亡（3.4％），原因是先前医疗失败的患者因感染源控制失败而导致败血症，放射学,和手术治疗。
■EUS引导盆腔脓肿引流术在技术上是可行的，安全,以及放射或开放式手术引流的有效替代方法。它还在不同的临床情况下提供有利的临床结果。
