Clinical application of ultrasound-guided percutaneous posterior approach for draining presacral abscesses / 中华医学超声杂志（电子版）

ABSTRACT

Objective To assess the value of percutaneous posterior ultrasound-guided transgluteal approach for draining presacral abscesses.Methods From June 2013 to December 2015,retrospectively reviewed were performed in 48 patients with presacral abscesses confirmed by CT or magnetic resonance imaging(MRI)were retrospectively reviewed,and these patients underwent percutaneous US-guided transgluteal abscess drainage and catheter placement.The medical records were reviewed to determine the origins,location,and size of the abscesses,size of catheter,duration of catheter drainage,incidence of catheter-related pain and procedure-related complications,and short and long-term outcomes.The duration of drainage among different size of drainage catheter was compared,and the correlation between the volume of abcess and duration of abcess drainage was analyzed.Results The origins of the pelvic abscesses included anastomotic leakage after colorectal cancer surgery(n=38)and congenital macrocolon operation(n=3),radiation proctitis(n=2),recurrence of rectal cancer complicated with intestinal perforation,Crohn disease(n=1),appendicitis with abscess formation(n=1),rectal fistula(n=1),and postoperative pancreatic pseudocyst(n=1).The abscesses were 24-135 mm in diameter.The volume of the abscesses was 4.8-283.4 ml.The sizes of catheters used were 8-12F,and the mean duration of drainage was 13 days(range:1-52).In 42(91.3%)of 46 patients,there was complete resolution of the abscess following transgluteal drainage,without subsequent surgery.In four of 46(8.7%)patients,incomplete resolution necessitated subsequent surgery.No significant difference in drainage time was observed among 8-16F catheters(all P ＞ 0.05).The volume of abscess was positively correlated with the drainage time(r=0.281,P＜0.05).No major complications were observed,either during or after the transgluteal procedure.Conclusion Percutaneous US-guided transgluteal drainage is a safe,effective and well tolerated alternative to surgery for deep pelvic abscesses,and thus is worthy of clinical application.