Minimally invasive retroperitoneoscopic surgery for psoas abscess with thoracolumbar tuberculosis.

Abstract

Minimally invasive retroperitoneoscopic surgery (MIS) for psoas abscess (PA) in patients with thoracolumbar tuberculosis is not well-illustrated and has not reached the status of being fully clinically assessed when we review the English literatures. The aim of this study is to introduce and investigate on efficacy and feasibility of MIS (retroperitoneoscopic technique) for PA in patients with thoracolumbar tuberculosis. From January 2008 to 2013, 39 consecutive patients of the diagnosis of PA with thoracolumbar tuberculosis received the debridement of abscesses and cavity walls of abscesses by the retroperitoneoscopic technique (MIS) in combination with anti-tuberculosis chemotherapy. Medical records and follow-up data were retrospectively studied. CRP and ESR of every patient preoperatively and postoperatively were analyzed Immediate relief in clinical symptoms and signs, and amelioration in imaging and laboratory examinations were obviously observed in all the patients. The follow-up had proceeded for 12-48 (mean 23) months. No complication was observed during the follow-up postoperatively. The retroperitoneoscopic technique for PA gain advantages in terms of shorter hospital stay, minimal invasiveness, absence of radiation, quicker recovery to daily life compared with percutaneous drainage, and anterior or posterior debridement surgery. Despite the technique not been fully clinically proved, it seems to be a recommended option as an effective diagnostic and therapeutic technique for PA, especially with massive or complicated PA.