Massive continuous irrigation (MCI) and endoscopic debridement as an alternative treatment strategy for refractory abscess-fistula complexes
© 2024 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd..
OBJECTIVE: To evaluate the feasibility, safety, and efficacy of massive continuous irrigation (MCI) and endoscopic debridement for the treatment of refractory abscess-fistula complexes.
METHODS: This was a retrospective single-center observational study involving 12 patients with refractory abscess-fistula complexes. All patients had experienced long-term treatment failure or had failed multiple treatment modalities. We used over two catheters and inserted them via the gastrointestinal (GI) tract or percutaneously to form a circulation pathway to achieve MCI of normal saline, endoscopic debridement was then performed. The treatment success rate, irrigation volume and treatment duration, time to abscess-fistula complex closure, intra-treatment complications, and recurrence rate were recorded.
RESULTS: The treatment success rates were 100%. The median time of previous treatment was 32 days (range 7-912 days). The mean time from the use of the novel treatment strategy to abscess-fistula complex healing was 18.8 ± 11.0 days. The mean volume of irrigation was 10 804 ± 1669 mL/24 h. The mean irrigation time was 16.5 ± 9.2 days, and a median of two irrigation tubes (range 2-5) were used. No complications occurred either during or after the procedure. During the follow-up of 23.1 ± 18.1 months, no recurrence or adverse events were noted.
CONCLUSIONS: MCI and endoscopic debridement may be a feasible, safe, and effective alternative treatment for refractory abscess-fistula complexes. Large prospective studies are needed to validate our results.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:25 |
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| Enthalten in: |
Journal of digestive diseases - 25(2024), 2 vom: 21. Feb., Seite 133-139 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Zhao, Yue [VerfasserIn] |
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| Links: |
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| Themen: |
Abscess |
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| Anmerkungen: |
Date Completed 12.04.2024 Date Revised 12.04.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1111/1751-2980.13257 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM370009908 |
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| 520 | |a © 2024 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd. | ||
| 520 | |a OBJECTIVE: To evaluate the feasibility, safety, and efficacy of massive continuous irrigation (MCI) and endoscopic debridement for the treatment of refractory abscess-fistula complexes | ||
| 520 | |a METHODS: This was a retrospective single-center observational study involving 12 patients with refractory abscess-fistula complexes. All patients had experienced long-term treatment failure or had failed multiple treatment modalities. We used over two catheters and inserted them via the gastrointestinal (GI) tract or percutaneously to form a circulation pathway to achieve MCI of normal saline, endoscopic debridement was then performed. The treatment success rate, irrigation volume and treatment duration, time to abscess-fistula complex closure, intra-treatment complications, and recurrence rate were recorded | ||
| 520 | |a RESULTS: The treatment success rates were 100%. The median time of previous treatment was 32 days (range 7-912 days). The mean time from the use of the novel treatment strategy to abscess-fistula complex healing was 18.8 ± 11.0 days. The mean volume of irrigation was 10 804 ± 1669 mL/24 h. The mean irrigation time was 16.5 ± 9.2 days, and a median of two irrigation tubes (range 2-5) were used. No complications occurred either during or after the procedure. During the follow-up of 23.1 ± 18.1 months, no recurrence or adverse events were noted | ||
| 520 | |a CONCLUSIONS: MCI and endoscopic debridement may be a feasible, safe, and effective alternative treatment for refractory abscess-fistula complexes. Large prospective studies are needed to validate our results | ||
| 650 | 4 | |a Observational Study | |
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| 650 | 4 | |a endoscopic debridement | |
| 650 | 4 | |a fistula | |
| 650 | 4 | |a soaking | |
| 650 | 4 | |a therapeutic irrigation | |
| 700 | 1 | |a Zhang, Ji Yu |e verfasserin |4 aut | |
| 700 | 1 | |a Ullah, Saif |e verfasserin |4 aut | |
| 700 | 1 | |a Zheng, Qing Fen |e verfasserin |4 aut | |
| 700 | 1 | |a Liu, Dan |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Meng |e verfasserin |4 aut | |
| 700 | 1 | |a Zhao, Li Xia |e verfasserin |4 aut | |
| 700 | 1 | |a Shi, Miao |e verfasserin |4 aut | |
| 700 | 1 | |a Li, De Liang |e verfasserin |4 aut | |
| 700 | 1 | |a Liu, Bing Rong |e verfasserin |4 aut | |
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