Percutaneous computed tomography-guided drainage of presacral fluid collections: a comprehensive analysis of 93 cases in a single-center experience

Purpose To retrospectively evaluate the safety and efficacy of computed tomography (CT)-guided drainage of presacral fluid collections. Methods The records of patients who underwent percutaneous CT-guided drainages of presacral fluid collections at our institution from January 2015 to October 2023 were retrospectively reviewed. Demographics and morphological data, procedural details, complications, and outcomes were analyzed. Results In all, 93 patients with 95 presacral fluid collections received percutaneous CT-guided drainages. A total of 117 procedures were performed with 18 patients who required re-drainages. Technical and radiological success rate of drainage placement procedures was, respectively, 98% and 78%. One of 93 [1%] patients experienced a minor complication from drainage placement. No major complications occurred. The preferred approach was left infrapiriformis transgluteal in prone position. Median drainage size was 10 Fr (range 6–14 Fr). Conclusions Percutaneous CT-guided drainage is a safe and effective treatment option for presacral fluid collections, which in selected cases can be used as an alternative to surgery or as a preparatory phase for it, with minor complications occurring rarely.