Retroperitoneoscopic drainage of complicated psoas abscesses in patients with tuberculous lumbar spondylitis

Abstract

Purpose Nowadays, endoscopic techniques are widely used in surgical procedures. Retroperitoneoscopy has been an extremely valuable tool for a wide variety of urologic disorders, whereas, it has limited use in orthopedic procedures. MethodsWe performed retroperitoneoscopic drainage (in combination with medical treatment) of complicated psoas abscess on 12 patients with tuberculous spondylitis. All the procedures were done under general anesthesia and in the lateral decubitus position. Psoas abscess was evacuated during procedure, and postoperatively, drainage was continued through a large silastic tube. The definitive diagnosis and the treatment were made based on the results of culture-antibiogram and PCR testing. Results Complete clinical and radiologic remission was observed in all patients in 3-6 months. The complication was not observed in any case postoperatively.Conclusions Retroperitoneoscopic drainage of psoas abscesses gains advantages in terms of rapid recovery, minimal invasiveness, absence of radiation, and shorter hospital stay. This procedure can be used not only for cold abscesses but also for other pathologies of lumbar vertebral area.

Retroperitoneoscopic drainage of bilateral psoas abscesses under intraoperative laparoscopic ultrasound guidance

“…It is better than open surgery in terms of rapid recovery and minimally invasiveness, and it allows for a more complete drainage. Moreover, it does not involve radiation like CT‐guided PCD . In addition, catheter dislocations or obstructions are known PCD complications , but those were avoided in the present case because a large drain was placed and fixed on the fascia of the psoas muscle.…”

“…This surgical procedure was first described by Katara et al in 2004 (1). To the best of our knowledge, there have only been two other English publications regarding retroperitoneoscopic drainage (8,9). It is better than open surgery in terms of rapid recovery and minimally invasiveness, and it allows for a more complete drainage.…”

Laparoscopic Drainage of Iliopsoas Abscess

“…To our knowledge, only three publications regarding laparoscopic drainage of psoas abscess have been reported in the English literature. 10,11,12 …”

Infectious Lesions of the Spine: Draft National Clinical Guidelines

“…Основной принцип хирургического лечения инфекционного спондилита -синдромно-нозологический [1,2,4,5,[8][9][10][43][44][45][46][47][48][49][50][51][52][53][54][55][56], а его целикупирование воспалительного процесса, восстановление стабильности и опороспособности позвоночника (стандарт).…”