Open Access

Clinical value of early laparoscopic therapy in the management of tubo‑ovarian or pelvic abscess

  • Authors:
    • Xiaofei Jiang
    • Mingqing Shi
    • Miao Sui
    • Tao Wang
    • Haiyan Yang
    • Huifang Zhou
    • Kai Zhao
  • View Affiliations

  • Published online on: June 21, 2019     https://doi.org/10.3892/etm.2019.7699
  • Pages: 1115-1122
  • Copyright: © Jiang et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Broad‑spectrum antibiotics are the conservative treatment for tubo‑ovarian abscess (TOA) or pelvic abscess, but the failure rate of antibiotic therapy remains higher in patients with a larger abscess. The present study aimed to evaluate the clinical value of early laparoscopic therapy in the management of TOA or pelvic abscess. A total of 100 patients were enrolled and their medical records were retrospectively analyzed after excluding 6 patients with malignant diseases. Based on the treatment they had received, the patients were divided into a conservative treatment group (n=41) and an early laparoscopic treatment group (n=53). In the conservative treatment group, 21 patients (51.2%) finally received laparoscopic exploration (late laparoscopic treatment group), and 20 patients (48.8%) achieved a success of antibiotic therapy (successful antibiotic therapy group). The cut‑off value of abscess size for predicting antibiotic treatment failure was determined using receiver operating characteristic curve analysis. Multivariate logistic regression analyses were used to explore the association between the clinical variables and antibiotic therapy failure in conservative treatment group. The durations of elevated temperature >38.0˚C and hospitalization were significantly longer in the conservative treatment group than those in the early laparoscopic treatment group (all P<0.001). The patients in the late laparoscopic treatment group had a larger abscess size than those in the successful antibiotic therapy group (6.2±1.8 cm vs. 4.8±1.4 cm, P=0.008). An abscess diameter of 5.5 cm was obtained as the cut‑off of antibiotic failure, and the sensitivity and specificity were 81.0 and 85.0%, respectively. An abscess diameter of ≥5.5 cm was independently associated with antibiotic failure (odds ratio=5.724; 95%CI: 2.025‑16.182; P=0.001). In conclusion, early laparoscopic treatment was associated with a better clinical prognosis than conservative treatment and late laparoscopic therapy for TOA or pelvic abscess patients.
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August-2019
Volume 18 Issue 2

Print ISSN: 1792-0981
Online ISSN:1792-1015

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Spandidos Publications style
Jiang X, Shi M, Sui M, Wang T, Yang H, Zhou H and Zhao K: Clinical value of early laparoscopic therapy in the management of tubo‑ovarian or pelvic abscess. Exp Ther Med 18: 1115-1122, 2019
APA
Jiang, X., Shi, M., Sui, M., Wang, T., Yang, H., Zhou, H., & Zhao, K. (2019). Clinical value of early laparoscopic therapy in the management of tubo‑ovarian or pelvic abscess. Experimental and Therapeutic Medicine, 18, 1115-1122. https://doi.org/10.3892/etm.2019.7699
MLA
Jiang, X., Shi, M., Sui, M., Wang, T., Yang, H., Zhou, H., Zhao, K."Clinical value of early laparoscopic therapy in the management of tubo‑ovarian or pelvic abscess". Experimental and Therapeutic Medicine 18.2 (2019): 1115-1122.
Chicago
Jiang, X., Shi, M., Sui, M., Wang, T., Yang, H., Zhou, H., Zhao, K."Clinical value of early laparoscopic therapy in the management of tubo‑ovarian or pelvic abscess". Experimental and Therapeutic Medicine 18, no. 2 (2019): 1115-1122. https://doi.org/10.3892/etm.2019.7699