Aim: Aspiration of the abscess cavity versus excision of capsule are still in debate for the capsulated, large, superficially located abscesses.
Material and methods: Twenty patients who had large, solitary, capsulated, and superficially located lobar abscesses were analyzed retrospectively to compare the efficiency of two different surgical approaches and their impact on postoperative antibiotic use and the length of hospital stay.
Results: Nine patients underwent the capsule excision and 11 patients had the aspiration of their abscesses. There were no differences in terms of age, sex, location of abscesses, and radiographic features. There were 3 residual/recurrence in the aspiration group, who needed a second aspiration whereas; no residual/recurrence was observed in the excision group. Postoperative utilization of antibiotics was significantly less in the excision group (Mean: 26.7 days in the excision group vs. 46.6 days in aspiration group). Length of hospital stay for the purpose of iv antibiotic administration was significantly shorter in the excision group in close correlation with iv antibiotic use.
Conclusion: Our study demonstrated that excision of abscess capsule was superior to aspiration in terms of efficiency of surgical intervention and postoperative cost of the treatment in a highly selected group of brain abscesses.