title: 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.
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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Surgery, Jinling Hospital, Medical School of Nanjing University, 305 East Zhongshan Road, Nanjing, 210002, China.
authors.forename: Guosheng
authors.initials: G
authors.lastname: Gu
authors.affiliation: Department of Surgery, Jinling Hospital, Medical School of Nanjing University, 305 East Zhongshan Road, Nanjing, 210002, China. JiananR@gmail.com.
authors.forename: Jianan
authors.initials: J
authors.lastname: Ren
authors.affiliation: Department of Surgery, Jinling Hospital, Medical School of Nanjing University, 305 East Zhongshan Road, Nanjing, 210002, China.|Center for the Study of Inflammatory Bowel Disease, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Song
authors.initials: S
authors.lastname: Liu
authors.affiliation: Department of Surgery, Jinling Hospital, Medical School of Nanjing University, 305 East Zhongshan Road, Nanjing, 210002, China.
authors.forename: Guanwei
authors.initials: G
authors.lastname: Li
authors.affiliation: Department of Gastrointestinal-Pancreatic Surgery, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
authors.forename: Yujie
authors.initials: Y
authors.lastname: Yuan
authors.affiliation: Department of Surgery, Jinling Hospital, Medical School of Nanjing University, 305 East Zhongshan Road, Nanjing, 210002, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Chen
authors.affiliation: Department of Surgery, Jinling Hospital, Medical School of Nanjing University, 305 East Zhongshan Road, Nanjing, 210002, China.|Department of General Surgery, Second Affiliated Hospital of Jilin University General Surgery, Center of Jilin University, Changchun, China.
authors.forename: Gang
authors.initials: G
authors.lastname: Han
authors.affiliation: Department of Surgery, Jinling Hospital, Medical School of Nanjing University, 305 East Zhongshan Road, Nanjing, 210002, China.
authors.forename: Huajian
authors.initials: H
authors.lastname: Ren
authors.affiliation: Department of Surgery, Jinling Hospital, Medical School of Nanjing University, 305 East Zhongshan Road, Nanjing, 210002, China.
authors.forename: Zhiwu
authors.initials: Z
authors.lastname: Hong
authors.affiliation: Department of Surgery, Jinling Hospital, Medical School of Nanjing University, 305 East Zhongshan Road, Nanjing, 210002, China.
authors.forename: Dongsheng
authors.initials: D
authors.lastname: Yan
authors.affiliation: Department of Surgery, Jinling Hospital, Medical School of Nanjing University, 305 East Zhongshan Road, Nanjing, 210002, China.
authors.forename: Xiuwen
authors.initials: X
authors.lastname: Wu
authors.affiliation: Department of Surgery, Jinling Hospital, Medical School of Nanjing University, 305 East Zhongshan Road, Nanjing, 210002, China.
authors.forename: Ning
authors.initials: N
authors.lastname: Li
authors.affiliation: Department of Surgery, Jinling Hospital, Medical School of Nanjing University, 305 East Zhongshan Road, Nanjing, 210002, China.
authors.forename: Jieshou
authors.initials: J
authors.lastname: Li
mesh_terms: D018784:Abdominal Abscess / Q000601:surgery*; D000328:Adult; D000368:Aged; D057785:Catheters; D004322:Drainage / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D011677:Punctures; D012189:Retrospective Studies; D016896:Treatment Outcome