Endoscopic ultrasound guided versus surgical transrectal drainage of pelvic abscesses. Issue 3 (4th May 2018)

• Record Type: Journal Article
• Authors: Meylemans, D. V. G.; Oostenbrug, L. E.; Bakker, C. M.; Sosef, M. N.; Stoot, J. H. M. B.; Belgers, H. J.
• Is Part Of: Acta chirurgica belgica. Volume 118:Issue 3(2018)
• Page Start: 181
• Page End: 187
• Publication Date: 2018-05-04
• Subjects: Pelvic abscess -- endoscopic ultrasound -- transrectal surgery -- drainage; Surgery -- Periodicals; General Surgery; Chirurgie -- Périodiques; Surgery; Chirurgie (geneeskunde); Periodicals; Periodicals; 617.005
• DOI: 10.1080/00015458.2017.1411549
• Languages: English
• ISSNs: 0001-5458

Abstract

Abstract: Background: Pelvic abscesses are common but only small case series reporting outcome of either endoscopic ultrasound (EUS) guided or surgical transrectal drainage have been reported. Methods: We performed a retrospective consecutive cohort study, assessing effectivity and safety of EUS guided or surgical transrectal drainage of previously untreated pelvic abscesses from all causes, diagnosed using CT scan between 09/2010 and 06/2014 in a Dutch teaching hospital. Results: Forty-six patients with comparable demographics, apart from stoma presence ( p = .016), were included. The success rate after a single intervention was 83% in the EUS guided compared to 48% in the surgical transrectal drainage group ( p = .013). However, the mean duration of drainage was threefold in the EUS group [42 versus 13 days ( p = .001)]. The length of stay in hospital was similar for both EUS and surgical group [24 versus 20 days ( p = .56)] as was abscess resolution during follow-up [78% versus 74%]. We recorded a total of 12 anastomotic leaks [3 versus 9]. In the occurrence of leakage, only one stoma was finally closed in each group. Conclusion: EUS guided and surgical transrectal drainage of pelvic abscesses from any cause are safe, nonetheless EUS guided drainage(if feasible) seems more effective after a single treatment, with high overall cure rates.