EUS-guided pelvic drainage: A systematic review and meta-analysis Dhindsa BS, Naga Y, Saghir SM, Dhaliwal A, Ramai D, Cross C, Singh S, Bhat I, Adler DG, - Endosc Ultrasound

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EUS-guided pelvic drainage: A systematic review and meta-analysis Banreet Singh Dhindsa¹, Yassin Naga², Syed Mohsin Saghir², Amaninder Dhaliwal³, Daryl Ramai⁴, Chad Cross⁵, Shailender Singh¹, Ishfaq Bhat¹, Douglas G Adler⁶ ¹ Division of Gastroenterology and Hepatology, University of Nebraska Medical Center, 982000 Nebraska Medical Center, Omaha, NE, USA ² Department of Internal Medicine, University of Nevada, Las Vegas School of Medicine, Las Vegas, NV, USA ³ Division of Gastroenterology and Hepatology, Moffitt Cancer Center, Tampa, FL, USA ⁴ Department of Internal Medicine, The Brooklyn Hospital Center, Brooklyn, New York, USA ⁵ Department of Biostatistics and Epidemiology, University of Nevada Las Vegas, Las Vegas, NV, USA ⁶ Department of Gastroenterology and Hepatology, University of Utah, School of Medicine, Huntsman Cancer Center, Salt Lake City, Utah, USA Correspondence Address: Douglas G Adler, University of Utah School of Medicine, Huntsman Cancer Center, 30 N 1900 E, Room 4R118, Salt Lake City, Utah 84132 USA Source of Support: None, Conflict of Interest: None DOI: 10.4103/eus.eus_71_20 PMID: 33463556

Background and Objectives: EUS-guided pelvic abscess drainage (EUS-PAD) is a procedure that utilizes an echoendoscope to visualize an area of interest for needle insertion and placement of a stent, catheter, or both for drainage of the target abscess. The aim of this study was to perform a systematic review and meta-analysis for the safety and efficacy of EUS-PAD. Materials and Methods: We conducted a comprehensive search of several databases and conference proceedings including PubMed, EMBASE, Google Scholar, MEDLINE, SCOPUS, and Web of Science databases (earliest inception to February 2020). The primary outcomes for this study were the technical and clinical success of EUS-PAD. The secondary outcomes assessed for this study were adverse events of the procedure and subgroup analysis of individual adverse events. Results: Eight studies with a total of 135 patients combined were included in our analysis. The rate of technical success was 100% and the calculated pooled rate of clinical success was 92% (95% confidence interval [CI]: 87%, 98%; P = 0.31; I² = 15%). The calculated pooled rate of adverse events was 9.4% (±17.9%), with stent migration (5.5 ± 18.06%) being the most common adverse event. Conclusion: EUS-PAD offers a viable alternative that can minimize the need for surgical intervention in the drainage of pelvic abscesses. EUS-PAD has also demonstrated long-term clinical success with an acceptable rate of complications.

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    -  Dhindsa BS
    -  Naga Y
    -  Saghir SM
    -  Dhaliwal A
    -  Ramai D
    -  Cross C
    -  Singh S
    -  Bhat I
    -  Adler DG

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