Preoperative Percutaneous Drainage of Spontaneous Intra-Abdominal Abscess in Patients With Crohn's Disease. Issue 9 (October 2015)

• Record Type: Journal Article
• Authors: He, Xiaosheng; Lin, Xutao; Lian, Lei; Huang, Juanni; Yao, Qiuqiong; Chen, Zexian; Fan, Dejun; Wu, Xiaojian; Lan, Ping
• Is Part Of: Journal of clinical gastroenterology. Volume 49:Issue 9(2015)
• Publication Date: 2015-10
• Subjects: Gastroenterology -- Periodicals; Digestive organs -- Diseases -- Periodicals; Gastroenterology -- Periodicals; Digestive organs -- Diseases; Gastroenterology; Periodicals; Periodicals; 616.33005
• DOI: 10.1097/MCG.0000000000000219
• Languages: English
• ISSNs: 0192-0790

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>Goals:</title> <p>We aimed to compare clinical outcomes between percutaneous drainage (PD) with or without further elective surgery and initial surgery for patients with Crohn's disease (CD)-related spontaneous intra-abdominal abscess.</p> </sec> <sec> <title>Background:</title> <p>Intra-abdominal abscess is common in patients with CD leading to significant morbidity. The role of PD before abdominal surgery in patients with CD remains controversial.</p> </sec> <sec> <title>Study:</title> <p>We performed a meta-analysis comparing PD and surgery as the initial approach to CD-related spontaneous intra-abdominal abscess. Overall complication and recurrent abscess were assessed. Subgroup analyses on initial PD were performed including preoperative PD and PD alone.</p> </sec> <sec> <title>Results:</title> <p>A total of 9 studies including 513 patients with CD-related spontaneous intra-abdominal abscesses were included. The overall complication rate was significantly higher in patients undergoing initial surgery compared with those undergoing initial PD [odds ratio (OR)=0.58; 95% confidence interval (CI), 0.35-0.96; <italic>P</italic>=0.03]. In a subgroup analysis, preoperative PD was associated with a significant reduction in overall complication (OR=0.44; 95% CI, 0.23-0.83; <italic>P</italic>=0.01) as compared with initial surgery. The risk for recurrent abscess was higher in patients who underwent PD alone than those who underwent initial surgery (OR=2.16; 95% CI, 1.03-4.54; <italic>P</italic>=0.04). No significance difference in postoperative recurrent abscess was found between preoperative PD group and initial surgery group.</p> </sec> <sec> <title>Conclusion:</title> <p>Although abdominal surgery appeared to be inevitable in the majority of the patients with CD who develop intra-abdominal abscess, preoperative PD may decrease overall complication after surgery.</p> </sec> </abstract>