Transgluteal approach for percutaneous XXXX : 154 cases.

@entity1 @entity43 @entity698 @entity548 @entity29 @entity530 @entity733 @entity158 @entity4436 @entity30 @entity526
PURPOSE: To assess the effectiveness of a computed tomographic (CT) image-guided transgluteal approach for percutaneous @entity530 as an alternative to surgical drainage. MATERIALS AND METHODS: The medical records of 140 @entity1 who underwent percutaneous CT-guided transgluteal drainage of 154 deep pelvic abscesses were reviewed to determine the origins, location, and size of the abscesses; volume of initial aspirate; organisms identified in fluid culture; duration of catheter drainage; incidence of catheter-related @entity158 and procedure-related complications; and short- and long-term outcomes. The resultant data were analyzed with a Fisher exact test for difference in the incidence of postprocedural catheter-site @entity158 between transpiriformis and infrapiriformis approaches. RESULTS: The origins of the pelvic abscesses included postoperative fluid collection (n = 115), perforating @entity698 (n = 6), @entity4436 (n = 16), @entity43 (n = 5), @entity30 (n = 10), and @entity29 due to irradiation (n = 2). The abscesses were 4-12 cm in diameter. The volume of the aspirate was 5-310 mL. Laboratory cultures of the aspirate grew mixed flora, but the organism most frequently isolated was @entity526 . Catheters were removed after a mean of 8 days. In 134 (96%) of 140 @entity1 , there was complete resolution of the @entity733 following transgluteal drainage, without subsequent surgery. In six of 140 (4%) @entity1 , incomplete resolution necessitated subsequent surgery for postoperative fluid collection (n = 3), @entity4436 (n = 2), or perforating @entity698 (n = 1). Complications of transgluteal drainage were rare and included @entity548 in three (2%) of the 140 @entity1 . There was no procedure-related mortality. A transpiriformis approach was significantly more likely to be associated with postprocedural @entity158 (P <.001) than was an infrapiriformis approach. CONCLUSION: Percutaneous CT-guided transgluteal drainage is a safe and effective alternative to surgery for deep pelvic abscesses. Major complications are rare.
