Surgical outcome of encapsulated brain abscess in superficial non-eloquent area: A systematic review.

Objective: To investigate surgical (aspiration and resection) outcome of encapsulated brain abscess in superficial non-eloquent area.

Methods: We searched Pubmed, Embase and Cochrane Library from the foundation of the database till December 2013. Two researchers screened literatures independently, assessed the quality of the included studies and extracted the data. Revman 5.2.8 was used to do meta-analysis.

Results: A total of five studies were included, all retrospective cohort studies. Eighty-four cases were in the abscess aspiration group and 124 cases were in the abscess resection group. Meta-analysis showed that the abscess resection group had lower rate of postoperative residual abscess, lower re-operation rate, higher rate of improvement in neurological status within 1 month after surgery, their OR (95% Confidence Interval (CI)) were 0.12 (0.04, 0.34), 0.07 (0.02, 0.20), 7.9 (3.20, 19.51) respectively; the abscess resection group had shorter duration of post-operative antibiotics and average length of hospital stay; Standard Mean Difference (SMD) (95% CI) were -0.84 (-1.27, -0.41), -1.01 (-1.54, -0.49), respectively. There was no statistically significant difference in the rate of improvement in neurological status at 3 months post-operative and the mortality.

Conclusions: Current evidences suggest that for encapsulated brain abscess in superficial non-eloquent area, abscess resection compared to abscess aspiration had lower post-operative residual abscess rate; lower re-operation rate; higher rate of improvement in neurological status within 1 month after surgery, shorter duration of post-operative antibiotics and average length of hospital stay. There was no statistically significant difference in the rate of improvement in neurological status at 3 months post-operative and the mortality.