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01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Surgery 1/2015

Comparative evaluation of sump drainage by trocar puncture, percutaneous catheter drainage versus operative drainage in the treatment of Intra-abdominal abscesses: a retrospective controlled study

Zeitschrift:
BMC Surgery > Ausgabe 1/2015
Autoren:
Guosheng Gu, MD, FACS Jianan Ren, Song Liu, Guanwei Li, Yujie Yuan, Jun Chen, Gang Han, Huajian Ren, Zhiwu Hong, Dongsheng Yan, Xiuwen Wu, Ning Li, Jieshou Li
Wichtige Hinweise
Guosheng Gu and Song Liu contributed equally to this work.

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

Study conception and design: GS, JA; Acquisition of data: GS, SL, YJ, XW, JC, GH; Analysis and interpretation of data: GS, SL, HJ, ZW, DS; Drafting of manuscript: GS, SL, GW; Critical revision: JA, NL, JS. All authors read and approved the final manuscript.

Abstract

Background

Intra-abdominal and pelvic abscesses are common and result from various illnesses. Percutaneous drainage applies limitedly to well-localized abscesses with appropriate density while surgical drainage usually causes significant physiological disturbance. We herein illustrated an innovative choice “sump drainage with trocar puncture” for the management of intra-abdominal abscesses and compare it with conventional percutaneous and surgical drainage in terms of clinical outcomes and prognosis.

Methods

Medical records of a total of 75 patients with abscesses were retrospectively retrieved and scrutinized. Data consisted of demographics, abscesses characteristics and treatment outcomes including postoperative complication, duration of hospitalization, postoperative recurrence of abscesses, subsequent surgery, ultimate stoma creation and survival rate. All enrolled patients were divided into trocar group (n = 30), percutaneous group (n = 20) and surgical group (n = 25) according to the therapeutic modalities. One-way ANOVA and t-test with Welch’s correction were used in continuous variables, and Chi-squared test as well as Fisher’s exact test for categorical variables. The cumulative incidence of subsequent surgery and ultimate stoma creation was also indicated by the Kaplan–Meier method and compared by log-rank test.

Results

The risk of ultimate stoma creation (p = 0.0069) and duration of postoperative hospitalization (p = 0.0077) were significantly decreased in trocar group compared with the surgical group. Patients receiving trocar puncture also tended to be less likely to have subsequent surgery (p = 0.097). Patients in trocar group displayed a lower rate of postoperative complication than the percutaneous (p = 0.0317) and surgical groups (p = 0.0175). As for Kaplan–Meier analysis, the cumulative incidence of ultimate stoma creation of the patients using sump drainage was also significantly different among three groups during follow-up period (p = 0.011).

Conclusion

This novel technique “sump drainage by trocar puncture” could produce better clinical outcomes and prognosis than conventional percutaneous drainage and surgical intervention. It might become an optimal choice in the management of intra-abdominal abscesses in the future.
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