Serour F, Somekh E, Krutman B, Gorenstein A
Department of Pediatric Surgery, The Edith Wolfson Medical Center, P.O. Box 5, Holon 58100, Israel.
Pediatr Surg Int. 2002 Mar;18(2-3):159-61. doi: 10.1007/s003830100683.
Controversy persists regarding the treatment of pilonidal sinus (PS). To evaluate the efficacy of excision with primary closure and closed-suction drainage in adolescent patients, between 1990 and 1999, 34 consecutive patients aged 13-18 years (mean 16.4) underwent PS excision with primary closure and suction drainage. Anesthesia was general in 16 (47%) and spinal in 18 (53%) with a statistical age difference ( P< 0.001) (15.5 vs 17.2 years, respectively). No complications due to the anesthetic were observed. Twenty-one patients (61.8%) had day-case surgery while the others were hospitalized for 2 to 4 days (average 2.3 days). The drain was removed on postoperative day 2 to 6 (average 2.2). Primary healing with no postoperative complications occurred in 30 patients (88.2%); 1 underwent partial opening of the wound because of rupture of the drainage tube during its removal. Postoperative infections requiring incision, drainage, and lay-open occurred in 3 cases (9.1%). No recurrence was found at 12-month follow-up. One recurrence (2.9%) was noted 3 years after surgery. Excision with primary closure and closed-suction drainage as an ambulatory procedure is thus a simple and effective method of treatment of uncomplicated PS in adolescents.
关于藏毛窦（PS）的治疗仍存在争议。为评估一期缝合联合闭式吸引引流术在青少年患者中的疗效，1990年至1999年间，34例年龄在13 - 18岁（平均16.4岁）的连续患者接受了一期缝合联合闭式吸引引流的PS切除术。16例（47%）采用全身麻醉，18例（53%）采用脊髓麻醉，存在统计学年龄差异（P < 0.001）（分别为15.5岁和17.2岁）。未观察到因麻醉引起的并发症。21例患者（61.8%）接受日间手术，其余患者住院2至4天（平均2.3天）。引流管在术后第2至6天拔除（平均2.2天）。30例患者（88.2%）一期愈合且无术后并发症；1例因拔除引流管时破裂导致伤口部分裂开。3例患者（9.1%）发生术后感染，需要切开、引流和敞开伤口。12个月随访时未发现复发。术后3年发现1例复发（2.9%）。因此，一期缝合联合闭式吸引引流作为一种门诊手术，是治疗青少年单纯性PS的一种简单有效的方法。
