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

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.