Abstract
To evaluate the safety and effectiveness of CT-guided percutaneous drainage of lung abscesses considering success rate versus complications. This retrospective study was carried out at Computed Tomography and Interventional Radiology Department of Sotiria Hospital, Athens, Greece, from 1/1/2007 to 1/1/2010. Forty patients with lung abscesses in which antibiotic therapy failed and were managed with CT-guided percutaneous drainage were included in the study. Catheter placement was carried out using Trocar technique in the majority of the cases. Lung abscess completely resolved with no residual cavity in thirty three patients. Seven patients had residual cavity and surgery was performed. Thus, the success rate of radiological drainage of the lung abscesses (33/40) was 83%. Five (13%) patients developed pneumothorax. Three developed moderate pneumothorax and chest-tube needed to be inserted and two patients developed mild pneumothorax which was managed with aspiration. These patients were kept under observation and followed-up by chest X-rays. No other complications and no mortality occurred during the procedure for all the forty patients. CT-guided percutaneous catheter drainage is a useful and safe procedure for the treatment of patients with lung abscesses who do not respond to medical therapy and should be considered a valuable alternative to open surgery.
Highlights
To evaluate the safety and effectiveness of CT-guided percutaneous drainage of lung abscesses considering success rate versus complications
80-90% of pyogenic lung abscesses are successfully treated with antibiotics [2], occasionally this conservative therapy may fail [3,4,5], which could be due to the virulence of the responsible pathogens or failure to achieve an adequate concentration of antibiotics within the abscess cavity [2, 6, 7]
Image guided percutaneous catheter drainage of intrapulmonary air and fluid collections is an alternative treatment option with less morbidity and mortality than surgical resection of intrapulmonary lung abscess of those patients who do not respond to medical therapy
Summary
To evaluate the safety and effectiveness of CT-guided percutaneous drainage of lung abscesses considering success rate versus complications. Forty patients with lung abscesses in which antibiotic therapy failed and were managed with CT-guided percutaneous drainage were included in the study. Conclusion: CT-guided percutaneous catheter drainage is a useful and safe procedure for the treatment of patients with lung abscesses who do not respond to medical therapy and should be considered a valuable alternative to open surgery. Image guided percutaneous catheter drainage of intrapulmonary air and fluid collections is an alternative treatment option with less morbidity and mortality than surgical resection of intrapulmonary lung abscess of those patients who do not respond to medical therapy. The purpose of the present retrospective study was to evaluate the results of CT-guided percutaneous drainage for lung abscesses in a hospital of chest diseases (Sotiria General Hospital of Chest Diseases, Athens, Greece) over a period of 36 months
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