Lumen-Apposing Metal Stents in the Management of Complex Pelvic Abscesses
Background: Lumen-apposing metal stents (LAMS) are utilized in a wide range of therapeutic gastrointestinal applications. We present our experience with LAMS-assisted drainage of complex pelvic abscesses at a large safety-net hospital. Methods: EUS-guided LAMS placements for pelvic abscesses from Ju...
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MDPI AG
2024-12-01
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| Online Access: | https://www.mdpi.com/2075-4418/14/24/2854 |
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| author | Kenneth W. Chow Nicholas A. Cumpian Ranjit Makar Pejman Zargar Fouzia Oza Idrees Suliman Viktor Eysselein Sofiya Reicher |
| author_facet | Kenneth W. Chow Nicholas A. Cumpian Ranjit Makar Pejman Zargar Fouzia Oza Idrees Suliman Viktor Eysselein Sofiya Reicher |
| author_sort | Kenneth W. Chow |
| collection | DOAJ |
| description | Background: Lumen-apposing metal stents (LAMS) are utilized in a wide range of therapeutic gastrointestinal applications. We present our experience with LAMS-assisted drainage of complex pelvic abscesses at a large safety-net hospital. Methods: EUS-guided LAMS placements for pelvic abscesses from July 2020 to June 2024 were analyzed. Data were collected on patient demographics, procedure indications, fluid collection size, stent characteristics, stent dwell time, and complications. All cases underwent multidisciplinary review with Surgery and Interventional Radiology (IR) prior to LAMS-assisted drainage; all were deemed not amenable to drainage by IR. Results: Eleven patients underwent EUS-guided drainage of complex pelvic abscesses with cautery-enhanced LAMS. Diverticulitis was the most common cause of abscesses (n = 6; 55%). The average time from presentation to drainage was 7 days (1–18). The average abscess size was 7.2 cm (3.9–12.0 cm). The most common LAMS size was 15 mm × 10 mm; each was placed through the left colon and rectum with both technical and clinical success. All abscesses completely resolved with a mean stent dwell time of 28 days (17–42 days). After stent removal, the fistula was not routinely closed. No complications such as stent migration, bleeding, or perforation occurred. There were no recurrences and no patients required additional surgical or IR procedures with a mean follow-up of 25 weeks (SD 35.6). Conclusions: Adequate drainage is the cornerstone of pelvic abscess management, but IR or surgical access can be challenging, with inadequate drainage and prolonged hospitalization leading to significant morbidity. In our experience, EUS-guided, LAMS-assisted drainage provides a safe and effective alternative for managing pelvic abscesses. |
| format | Article |
| id | doaj-art-7df4af98822249f9bd5b3bf62b5e1107 |
| institution | DOAJ |
| issn | 2075-4418 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj-art-7df4af98822249f9bd5b3bf62b5e11072025-08-20T02:53:43ZengMDPI AGDiagnostics2075-44182024-12-011424285410.3390/diagnostics14242854Lumen-Apposing Metal Stents in the Management of Complex Pelvic AbscessesKenneth W. Chow0Nicholas A. Cumpian1Ranjit Makar2Pejman Zargar3Fouzia Oza4Idrees Suliman5Viktor Eysselein6Sofiya Reicher7Department of Medicine, Harbor-UCLA Medical Center, Torrance, CA 90502, USADepartment of Medicine, Harbor-UCLA Medical Center, Torrance, CA 90502, USADepartment of Medicine, Harbor-UCLA Medical Center, Torrance, CA 90502, USADepartment of Medicine, Harbor-UCLA Medical Center, Torrance, CA 90502, USADepartment of Medicine, Harbor-UCLA Medical Center, Torrance, CA 90502, USADepartment of Medicine, Harbor-UCLA Medical Center, Torrance, CA 90502, USADepartment of Medicine, Harbor-UCLA Medical Center, Torrance, CA 90502, USADepartment of Medicine, Harbor-UCLA Medical Center, Torrance, CA 90502, USABackground: Lumen-apposing metal stents (LAMS) are utilized in a wide range of therapeutic gastrointestinal applications. We present our experience with LAMS-assisted drainage of complex pelvic abscesses at a large safety-net hospital. Methods: EUS-guided LAMS placements for pelvic abscesses from July 2020 to June 2024 were analyzed. Data were collected on patient demographics, procedure indications, fluid collection size, stent characteristics, stent dwell time, and complications. All cases underwent multidisciplinary review with Surgery and Interventional Radiology (IR) prior to LAMS-assisted drainage; all were deemed not amenable to drainage by IR. Results: Eleven patients underwent EUS-guided drainage of complex pelvic abscesses with cautery-enhanced LAMS. Diverticulitis was the most common cause of abscesses (n = 6; 55%). The average time from presentation to drainage was 7 days (1–18). The average abscess size was 7.2 cm (3.9–12.0 cm). The most common LAMS size was 15 mm × 10 mm; each was placed through the left colon and rectum with both technical and clinical success. All abscesses completely resolved with a mean stent dwell time of 28 days (17–42 days). After stent removal, the fistula was not routinely closed. No complications such as stent migration, bleeding, or perforation occurred. There were no recurrences and no patients required additional surgical or IR procedures with a mean follow-up of 25 weeks (SD 35.6). Conclusions: Adequate drainage is the cornerstone of pelvic abscess management, but IR or surgical access can be challenging, with inadequate drainage and prolonged hospitalization leading to significant morbidity. In our experience, EUS-guided, LAMS-assisted drainage provides a safe and effective alternative for managing pelvic abscesses.https://www.mdpi.com/2075-4418/14/24/2854LAMSpelvicabscessEUSdrainage |
| spellingShingle | Kenneth W. Chow Nicholas A. Cumpian Ranjit Makar Pejman Zargar Fouzia Oza Idrees Suliman Viktor Eysselein Sofiya Reicher Lumen-Apposing Metal Stents in the Management of Complex Pelvic Abscesses Diagnostics LAMS pelvic abscess EUS drainage |
| title | Lumen-Apposing Metal Stents in the Management of Complex Pelvic Abscesses |
| title_full | Lumen-Apposing Metal Stents in the Management of Complex Pelvic Abscesses |
| title_fullStr | Lumen-Apposing Metal Stents in the Management of Complex Pelvic Abscesses |
| title_full_unstemmed | Lumen-Apposing Metal Stents in the Management of Complex Pelvic Abscesses |
| title_short | Lumen-Apposing Metal Stents in the Management of Complex Pelvic Abscesses |
| title_sort | lumen apposing metal stents in the management of complex pelvic abscesses |
| topic | LAMS pelvic abscess EUS drainage |
| url | https://www.mdpi.com/2075-4418/14/24/2854 |
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