Outcomes of Minimally Invasive Management of Tubo-ovarian Abscess: A Systematic Review

ObjectiveTo compare the success rate, complications, and hospital length-of-stay of 3 modalities minimally invasive management tubo-ovarian abscesses (TOAs): laparoscopy, ultrasound-guided drainage, computed tomography–guided drainage.Data SourcesElectronic-based search in PubMed, EMBASE, Ovid MEDLINE, Google Scholar, Cochrane Central Register Controlled Trials, using following Medical Subject Heading terms: “minimally surgical procedures,” “drainage,” “abscess,” “tubo-ovarian,” “ovarian diseases,” “fallopian tube diseases.”Methods Study SelectionOf 831 articles initial results, 10 studies were eligible for inclusion our systematic review.Tabulation, Integration, ResultsA total 975 patients included study; 107 (11%) had laparoscopic drainage procedures, 406 (42%) image-guided (ultrasound or tomography) TOAs. Image-guided TOA higher rates (90%–100%) than (89%–96%) use antibiotic treatment alone (65%–83%). Patients treated with no complications (for up to 6 months follow-up) shorter lengths stay (0–3 days on average) compared (5–12 days) conservative antibiotics (7–9 days).ConclusionAlthough TOAs remains first-line, review indicates that better outcomes achieved by approach only. Of techniques, provided highest rates, fewest shortest stays laparoscopy. The low magnitude evidence calls further randomized trials. This was registered International Prospective Systematic Review (register, http://www.crd.york.ac.uk/PROSPERO;CRD 42020170345).