Gips Moshe, Melki Yedidia, Salem Leon, Weil Ruben, Sulkes Jaqueline
Pilonidal Sinus Clinic, Surgical Unit, Military Medical Facility, Zerifin, Israel.
Dis Colon Rectum. 2008 Nov;51(11):1656-62; discussion 1662-3. doi: 10.1007/s10350-008-9329-x. Epub 2008 May 31.
This study describes and reports the results of a new, minimally-invasive surgical technique for pilonidal disease.
From March 1993 to January 2003, 1,358 patients (out of a total of 1,435 patients) with symptomatic pilonidal disease underwent treatment in a military surgical clinic dedicated for pilonidal disease. Patients were operated on under local anesthesia, utilizing trephines to excise pilonidal pits and to débride underlying cavities and tracts.
One thousand three hundred fifty-eight symptomatic patients participated in the study and were mostly male (84.3 percent) and the mean age 20.9 +/- 3.6 years. Rates of postoperative infection, secondary bleeding, and early failure were 1.5, 0.2, and 4.4 percent, respectively. In patients with full postoperative clinical attendance, complete healing was observed within 3.4 +/- 1.9 weeks. Phone interview included 1,165 patients (85.8 percent) with a mean follow-up interval of 6.9 +/- 1.8 years. Recurrence rates after 1 year was 6.5 percent, 5 years was 13.2 percent, and 10 years was 16.2 percent. Mean time to recurrence was 2.7 +/- 2.6 years postoperatively. The disease-free probability estimate was 93.5 percent at one year and 86.5 percent at 5 years.
Compared with frequently used pilonidal operations, the trephine technique is associated with a lower recurrence rate and a low postoperative morbidity rate.
本研究描述并报告一种用于藏毛窦疾病的新型微创手术技术的结果。
1993年3月至2003年1月，在一家专门治疗藏毛窦疾病的军队外科诊所，对1435例有症状的藏毛窦疾病患者中的1358例进行了治疗。患者在局部麻醉下接受手术，使用环钻切除藏毛窦坑并清理下方的腔隙和管道。
1358例有症状的患者参与了本研究，大多数为男性（84.3%），平均年龄20.9±3.6岁。术后感染、继发性出血和早期失败率分别为1.5%、0.2%和4.4%。在术后完全接受临床随访的患者中，3.4±1.9周内观察到完全愈合。电话随访包括1165例患者（85.8%），平均随访间隔为6.9±1.8年。1年后复发率为6.5%，5年后为13.2%，10年后为16.2%。术后复发的平均时间为2.7±2.6年。1年时无病概率估计为93.5%，5年时为86.5%。
与常用的藏毛窦手术相比，环钻技术的复发率较低，术后发病率也较低。
