Routine Surgical Drainage in Tubo-ovarian Abscess: Single Center Experience with Fifty Patients

Year 2019, Volume: 4 Issue: 3, 52 - 58, 30.09.2019

Aysu Akca , Gulseren Yilmaz Nevin Tuten , Berna Aslan Cetin

Abstract

Backround: Current data concerning the role of
routine surgical drainage on patient outcomes and surrogate markers of
infection in patients with tubo-ovarian abscess (TOA) is limited. The present
retrospective study purposed to identify the impact of routine surgical
drainage on patients’ outcomes and postoperative leukocyte count, CRP level and
procalcitonin level which might improve our understanding on the role of
surgical drainage on infectious process in patients with TOA.

 Materials and Methods: Fifty
patients admitted to our institute (tertiary center) with TOA and underwent
surgical abscess drainage were enrolled in this retrospective analysis.
Demographic data, laboratory measurements during hospitalization,
antibiotherapy and operation details were obtained from institutional
electronic database. Perioperative complications were also derived from the
institutional database.

Results: The
most common microorganisms isolated from the abscess fluid cultures were
Klebsiella pneumonia (20%), Enterobacter aerogenes (16 %) and Escherichia coli
(16 %). The mean time from admission to antibiotherapy was 0.6 ± 0.2 days and
time from admission to surgery was 3.2 ± 2.8 days. Time from admission to
surgical drainage was 3.2 ± 2.8 days. Compared to admission values, the post-surgery
(at 48th hour) leukocyte count (15.3 ± 7.1 x103/mm3
vs. 12.4 ± 5.2 x103/mm3, p < 0.001), CRP (48.4 ± 35.3
mg/L vs. 9.8 ± 3.5 mg/L, p < 0.001) and procalcitonin levels (2.2 ± 1.8 µg/L
vs. 1.1 ± 0.8 µg/L, p < 0.001) were significantly lower. The overall complication
rate was 8 %.

Conclusions: Routine TOA drainage leads to a
significant decline in levels of infectious markers such as leukocyte count,
CRP and procalcitonin levels, within 48 hours of the surgery. Routine surgical
abscess drainage appears as a safe and effective way of treating patients with
TOA.

Keywords

Tubo-ovarian abscess, surgical drainage, C-reactive protein, procalcitonin

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