Egyptian Journal of Chest Disease and Tuberculosis (Jan 2018)

The role of ultrasound-guided nephrostomy catheter drainage in the management of peripheral pyogenic lung abscess

  • Amira A Gaballah,
  • Alaa Eldin M Elgazzar,
  • Hanan M Elshahat,
  • Abdul Raheem I Yusuf,
  • H. Takwa

DOI
https://doi.org/10.4103/ejcdt.ejcdt_17_17
Journal volume & issue
Vol. 67, no. 1
pp. 38 – 45

Abstract

Read online

Introduction Mortality from lung abscesses continue to be substantial, even with surgical therapy, ranging from 15 to 20%. Image-guided percutaneous transthoracic drainage (PTD) improved lung abscess management and avoid complications of prolonged conservative treatment. Aim The aim of the study was to assess the outcome of nephrostomy catheter ultrasound (US)-guided PTD on lung abscess treatment in comparison to postural drainage in addition to medical treatment. Patients and methods A total of 30 patients with peripheral lung abscess were randomly assigned into two groups, the interventional group where US-guided percutaneous nephrostomy catheter was inserted in addition to medical treatment and the control group where postural drainage was done in addition to medical treatment. The following was done for all patients: thorough medical examination, neurological examination, routine laboratory investigations, radiological investigations (chest radiography, chest computed tomography, chest US), sputum culture and sensitivity. Results The study included 30 patients with lung abscess 18 men, and 12 women with a mean age of 44.6±9.5 years, (P>0.05). Regarding the outcome, success was higher among patients treated with catheter drainage 13/15 (86.6%) versus 8/15 (53.3%) patients in the control group (P<0.001), failure rate was less in the interventional group two (13.3%) versus seven (46.7%) patients in the control group (P<0.001); the treatment duration in the interventional group was significantly shorter 14.4±2.8 versus 26.9±3.8 days in the control group (P<0.001). Both groups were comparable regarding age, sex, abscess size, smoking, comorbidities and the distance between the abscess and chest wall. There were no reported major complications in the interventional group. Conclusion US-guided PTD using nephrostomy catheter for peripheral lung abscess is safe and effective; it can improve the outcome, shorten the duration and reduce the need for surgery in lung abscess treatment with less complications.

Keywords