Endoscopy 2019; 51(04): S178-S179
DOI: 10.1055/s-0039-1681698
ESGE Days 2019 ePoster podium presentations
Saturday, April 6, 2019 13:00 – 13:30: EUS therapeutic miscelaneous ePoster Podium 5
Georg Thieme Verlag KG Stuttgart · New York

EUS-GUIDED TANS-RECTAL TREATMENT FOR SYMPTOMATIC PELVIC COLLECTIONS: PUNCTURE/ASPIRATION OR DRAINAGE? RESULTS FROM A LARGE MONOCENTRIC STUDY

JM Gonzalez
1   Gastroenterology, Hôpital Nord, AP-HM, Aix-Marseille Université, Marseille, France
,
M Guingand
1   Gastroenterology, Hôpital Nord, AP-HM, Aix-Marseille Université, Marseille, France
,
M Gasmi
1   Gastroenterology, Hôpital Nord, AP-HM, Aix-Marseille Université, Marseille, France
,
M Barthet
1   Gastroenterology, Hôpital Nord, AP-HM, Aix-Marseille Université, Marseille, France
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

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Aims:

Abdomino-pelvic symptomatic collections have recently been managed endoscopically by EUS-guideed transrectal drainage (EUS-TRD). We pesent the result of our experience. The main objective was to elucidate the acute efficacy of EUS-TRD (symptoms resolution). The secondary objectives were to document the morbidity, the recurrence (after one month), and to identify predictive factors for failure (persisting of symptomatic collection despite drainage +/- need for surgery).

Methods:

This was a retrospective monocentric observational study conducted from 2004 to 2018 in a tertiary center. The patients referred for pelvic symptomatic collection (pain or abscess) confirmed by imaging (CT-scan or MRI), whom underwent EUS-TRD were included.

The procedures were realized with therapeutic linear EUS-scopes under C02, performing either a aspiration + antibiotics injection, or drainage.

Results:

73 patients were included and divided in two groups: 1/patients undergoing puncture/aspiration/Amikacin injection (n = 30; 41%); 2/patients undergoing a drainage (n = 43; 58.9%) with plastic stents/drain (95.3%) or metal stents (4.6%).

The mean age was 42.5 years [12 – 87]. The collection was peri-rectal lin 67%, perianal in 28% and perisigmoid in 3.2%. In 55%, the abscess was post-operative and in 45% due to medical diseases. The mean size of the collections was 48.9 mm [8 – 120]. It was 33 +/- 17 mm in group 1 versus 67 +/- 21 mm in group 2 (p < 0,0001), influencing probably the choice of method.

The technical success was 100%. The clinical success was achieved in 95.8% of patients (70/73). It was 82.3% (28/30) in group 1 versus 97.7% (42/43) in group 2 (NS). There was no per or post operative complication. During a median follow-up of 7.5 years [4.4 – 8.9], no patient had any recurrence of the collection.

Conclusions:

EUS-TRD in treatment of pelvic abscesses is highly effective and safe, whatever the approach applied (aspiration or drainage) without recurrence during long term follow-up.