Pelvic abscess after colon and rectal surgery — What is optimal management?

摘要: PURPOSE: The aim of this study was to compare treatment outcomes in the management pelvic abscess (PA) after rectal surgery. METHODS: Over a 12-year period all PAs occurring patients undergoing colorectal resection were retrospectively reviewed. APACHE II Score used stratify illness. RESULTS: Postoperative PA developed 56 cancer (32 percent), ulcerative colitis (26 diverticular disease (24 and Crohn's (18 percent)/surgery. Overall, 24 (43 percent) operations for inflammatory bowel 43(77 intrapelvic intestinal anastomoses. treated by 1) antibiotics alone (11/56), 2) percutaneous computerized tomography-guided catheter drainage (13/56), 3) transperineal (15/56), or 4) laparotomy (17/56). Recurrent 11/56 (19 initial treatment, which 7 required additional These recurrences evenly distributed between groups. There three deaths as result PA, two one drainage. Long-term sequela with anastomosis included loss continuity (10/43) anastomotic stenosis (7/43). no difference among four mortality rate 75 percent whose Scores greater than 15. development colon surgery associated 5 41 functional morbidity (23 permanent stoma 18 symptomatic stricture rate). CONCLUSION: Using clinical judgment, if is amenable tomographyguided drainage, these techniques should be attempted initially hemodynamically stable nonseptic patient. disability common rectosigmoid who undergo pelvic/intestinal anastomosis.