Comparison between the Transperitoneal and Retroperitoneal Approach Methods for Severe Retroperitoneal Abscess

Abstract

Purpose: Retroperitoneal (RP) abscess is a rare condition with poor prognosis, unclear etiology, characteristics, and treatment. This study compared transperitoneal and RP approach methods in the treatment of RP abscess. Methods: There were 45 patients with RP abscess diagnosed at Inha University Hospital from January 2014 to August 2018, of which 22 patients with 2 RP zones and systemic inflammatory response syndrome were included. Characteristics, etiology, laboratory and radiological findings, surgical technique, complications, and total number of hospital days were examined. Patients were assigned to either the transperitoneal (TP) or RP approach group. Results: There were 22 patients with RP abscess who were treated with surgical drainage using either the TP (<i>n</i> = 13) or RP (<i>n</i> = 9) approach. There was no difference in characteristics between the 2 groups. The number of reinterventions in the RP group (<i>n</i> = 6) was more than in the TP group (<i>n</i> = 4; <i>p</i> = 0.02). Mortality in the TP group (<i>n</i> = 5) was higher than in the RP group (<i>n</i> = 1; p < 0.01). The total mean number of hospital days in the RP group (mean: 76, range: 29-180 days) was more than in the TP group (mean: 58, range: 18-280 days, <i>p</i> = 0.03). Conclusion: RP abscess requires rapid drainage using the TP or RP approach. Reintervention events and number of hospital days in the RP group was greater than the TP group; however, mortality in the RP group was lower than in the TP group.