Mueller X, Rothenbuehler J M, Frede K E
Departement Chirurgie, Kantonsspital Basel, Suisse.
J Chir (Paris). 1991 Nov;128(11):487-90.
The benignancy of sacrococcygeal cysts stands in contrast to their morbidity and rate of recurrence. Due to the differences in the results found in the literature and to the lack of recommendations as to the optimal surgical procedure, the authors have reviewed a series of 69 patients with a chronic inflammatory state. The procedure was either exeresis up to the sacrum (37 patients) or Lord Millar's procedure (32 patients). The latter consisted in a limited exeresis of the portals and in the extraction of the hairs with a brush, followed in principle by a weekly depilatory treatment until the wound was closed. The results in the 2 groups have been compared. Sixty-six patients (87%) were controlled after an average of 3.7 years. The shorter stay in hospital of the patients operated with Lord Millar's procedure (4.9 vs. 7.6 days) and the shorter period of inability to work (14 vs. 26 days) demonstrate the socioeconomical advantage of this procedure. Recurrence occurred in 5 of the 31 patients controlled after exeresis (16%) and in 7 of the 29 patients controlled after a Lord Millar's operation (24%), including one in the subgroup of 16 patients who submitted themselves to a regular postoperative epilatory treatment (6%) and 6 in the group of 13 who were not followed up in our clinic (46%). Thus Lord Millar's procedure represents an alternative to exeresis, provided the patient is motivated enough to submit himself to regular postoperative controls.
骶尾部囊肿的良性特征与其发病率和复发率形成对比。由于文献报道结果存在差异，且缺乏关于最佳手术方法的建议，作者回顾了69例处于慢性炎症状态的患者。手术方式为骶骨切除术（37例）或米勒勋爵手术（32例）。后者包括有限切除窦道和用刷子拔除毛发，原则上随后每周进行脱毛治疗直至伤口愈合。对两组结果进行了比较。66例患者（87%）在平均3.7年后得到随访。接受米勒勋爵手术的患者住院时间较短（4.9天对7.6天），无法工作的时间较短（14天对26天），这表明了该手术的社会经济优势。在接受骶骨切除术后接受随访的31例患者中，有5例复发（16%）；在接受米勒勋爵手术后接受随访的29例患者中，有7例复发（24%），其中包括16例接受术后定期脱毛治疗亚组中的1例（6%）和13例未在我们诊所接受随访的患者中的6例（46%）。因此，米勒勋爵手术是骶骨切除术的一种替代方法，前提是患者有足够的积极性接受术后定期检查。
