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Outcomes of percutaneous drainage without surgery for patients with diverticular abscess

BACKGROUND: Data on percutaneous drainage followed by observation for diverticular abscess is scant. OBJECTIVE: The aim of this study is to assess outcomes of percutaneous drainage alone in the management of peridiverticular abscess. DESIGN: This is a retrospective study from a prospectivel...

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Main Authors: Faisal, Elagili, Luca, Stocchi, Gokhan, Ozuner, David W, Dietz, Ravi P, Kiran
Format: Article
Language:English
English
English
Published: Wolters Kluwer 2014
Subjects:
RD Surgery
Online Access:http://irep.iium.edu.my/69704/1/elagili%20outcome.pdf
http://irep.iium.edu.my/69704/7/WOS%20Elagili.pdf
http://irep.iium.edu.my/69704/8/Scopus%20Elagili.pdf
http://irep.iium.edu.my/69704/
https://journals.lww.com/dcrjournal/toc/2014/03000
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spelling my.iium.irep.697042023-06-26T04:33:16Z http://irep.iium.edu.my/69704/ Outcomes of percutaneous drainage without surgery for patients with diverticular abscess Faisal, Elagili Luca, Stocchi Gokhan, Ozuner David W, Dietz Ravi P, Kiran RD Surgery BACKGROUND: Data on percutaneous drainage followed by observation for diverticular abscess is scant. OBJECTIVE: The aim of this study is to assess outcomes of percutaneous drainage alone in the management of peridiverticular abscess. DESIGN: This is a retrospective study from a prospectively collected database. SETTING: This study was conducted in a high-volume, specialized colorectal surgery unit. PATIENTS: All patients with a diverticular abscess of at least 3 cm in diameter, treated between 2001 and 2012, who had prohibitive comorbidities or refused surgery after percutaneous drainage were included. MAIN OUTCOME MEASURES: The primary outcome measured was the treatment of diverticular abscess with percutaneous drainage alone. RESULTS: A total of 18 patients (11 surgery refusal, 7 comorbidity) were followed up until death, surgery for recurrent diverticulitis, or for a median of 90 (17–139) months. The median abscess size was 5 (3.8–10) cm, and the location was pelvic in 8 cases and intra-abdominal in 10. The mean duration of drainage was 20 ± 1.3 days, with the exception of 2 patients who only had aspiration of the abscess because of technical difficulty in drain placement. Three patients died of preexisting comorbidities between 2 and 8 months after percutaneous drainage. Seven of the surviving patients (7/15) experienced recurrent diverticulitis; 3 of these patients underwent surgery between 7 months and 7 years after the index percutaneous drainage. Of the remaining 4 cases of recurrence, one abscess was treated with repeat percutaneous drainage alone and 3 patients had uncomplicated diverticulitis treated with antibiotics. There were no significant associations between long-term failure of percutaneous drainage and the location of the abscess ( p = 0.54) or previous episodes of diverticulitis ( p = 0.9). LIMITATIONS: This study was limited because of its retrospective nature, its nonrandomized design, and its small sample size. CONCLUSIONS: Percutaneous drainage alone was successful in avoiding surgery in the majority of this selected patient population with sigmoid diverticular abscess. Future studies should assess the appropriate indications for a more liberal use of percutaneous drainage not followed by elective surgery. Wolters Kluwer 2014-03 Article PeerReviewed application/pdf en http://irep.iium.edu.my/69704/1/elagili%20outcome.pdf application/pdf en http://irep.iium.edu.my/69704/7/WOS%20Elagili.pdf application/pdf en http://irep.iium.edu.my/69704/8/Scopus%20Elagili.pdf Faisal, Elagili and Luca, Stocchi and Gokhan, Ozuner and David W, Dietz and Ravi P, Kiran (2014) Outcomes of percutaneous drainage without surgery for patients with diverticular abscess. Diseases of the Colon & Rectum, 57 (3). pp. 331-336. ISSN 0012-3706 E-ISSN 1530-0358 https://journals.lww.com/dcrjournal/toc/2014/03000 10.1097/DCR.0b013e3182a84dd2
institution Universiti Islam Antarabangsa Malaysia
building IIUM Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider International Islamic University Malaysia
content_source IIUM Repository (IREP)
url_provider http://irep.iium.edu.my/
language English
English
English
topic RD Surgery
spellingShingle RD Surgery
Faisal, Elagili
Luca, Stocchi
Gokhan, Ozuner
David W, Dietz
Ravi P, Kiran
Outcomes of percutaneous drainage without surgery for patients with diverticular abscess
description BACKGROUND: Data on percutaneous drainage followed by observation for diverticular abscess is scant. OBJECTIVE: The aim of this study is to assess outcomes of percutaneous drainage alone in the management of peridiverticular abscess. DESIGN: This is a retrospective study from a prospectively collected database. SETTING: This study was conducted in a high-volume, specialized colorectal surgery unit. PATIENTS: All patients with a diverticular abscess of at least 3 cm in diameter, treated between 2001 and 2012, who had prohibitive comorbidities or refused surgery after percutaneous drainage were included. MAIN OUTCOME MEASURES: The primary outcome measured was the treatment of diverticular abscess with percutaneous drainage alone. RESULTS: A total of 18 patients (11 surgery refusal, 7 comorbidity) were followed up until death, surgery for recurrent diverticulitis, or for a median of 90 (17–139) months. The median abscess size was 5 (3.8–10) cm, and the location was pelvic in 8 cases and intra-abdominal in 10. The mean duration of drainage was 20 ± 1.3 days, with the exception of 2 patients who only had aspiration of the abscess because of technical difficulty in drain placement. Three patients died of preexisting comorbidities between 2 and 8 months after percutaneous drainage. Seven of the surviving patients (7/15) experienced recurrent diverticulitis; 3 of these patients underwent surgery between 7 months and 7 years after the index percutaneous drainage. Of the remaining 4 cases of recurrence, one abscess was treated with repeat percutaneous drainage alone and 3 patients had uncomplicated diverticulitis treated with antibiotics. There were no significant associations between long-term failure of percutaneous drainage and the location of the abscess ( p = 0.54) or previous episodes of diverticulitis ( p = 0.9). LIMITATIONS: This study was limited because of its retrospective nature, its nonrandomized design, and its small sample size. CONCLUSIONS: Percutaneous drainage alone was successful in avoiding surgery in the majority of this selected patient population with sigmoid diverticular abscess. Future studies should assess the appropriate indications for a more liberal use of percutaneous drainage not followed by elective surgery.
format Article
author Faisal, Elagili
Luca, Stocchi
Gokhan, Ozuner
David W, Dietz
Ravi P, Kiran
author_facet Faisal, Elagili
Luca, Stocchi
Gokhan, Ozuner
David W, Dietz
Ravi P, Kiran
author_sort Faisal, Elagili
title Outcomes of percutaneous drainage without surgery for patients with diverticular abscess
title_short Outcomes of percutaneous drainage without surgery for patients with diverticular abscess
title_full Outcomes of percutaneous drainage without surgery for patients with diverticular abscess
title_fullStr Outcomes of percutaneous drainage without surgery for patients with diverticular abscess
title_full_unstemmed Outcomes of percutaneous drainage without surgery for patients with diverticular abscess
title_sort outcomes of percutaneous drainage without surgery for patients with diverticular abscess
publisher Wolters Kluwer
publishDate 2014
url http://irep.iium.edu.my/69704/1/elagili%20outcome.pdf
http://irep.iium.edu.my/69704/7/WOS%20Elagili.pdf
http://irep.iium.edu.my/69704/8/Scopus%20Elagili.pdf
http://irep.iium.edu.my/69704/
https://journals.lww.com/dcrjournal/toc/2014/03000
_version_ 1769841817601179648
score 13.211869

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