Doll Dietrich, Matevossian Edouard, Wietelmann Kai, Evers Theo, Kriner Monika, Petersen Sven
Department of Visceral, Vascular, and Thoracic Surgery, Philipps-University of Marburg, Marburg, Germany.
Dis Colon Rectum. 2009 Sep;52(9):1610-5. doi: 10.1007/DCR.0b013e3181a87607.
It has long been suspected that a family history of pilonidal sinus disease may predispose to higher disease incidence. The influence of family history on recurrence rate has not been investigated. The purpose of this study was to evaluate the recurrence rate in patients with both a personal and a family history of pilonidal sinus disease.
A standardized telephone interview was used to retrospectively study 578 patients who underwent primary surgery between 1980 and 1996. Differences concerning the long-term recurrence rate between patients with a positive or negative family history were analyzed using Kaplan-Meier statistics.
Sixty-eight of 578 patients (12%) had a positive family history with first-degree relatives, in which 28 brothers and 25 fathers were similarly involved. The long-term recurrence rate was significantly elevated when family history was positive (35% vs. 22% after 15 years and 52% vs. 28% after 25 years; P = 0.02). The long-term recurrence rate was elevated if surgery was needed at a younger age (P = 0.03). The body mass index measured at time of admission for surgery did not seem to have any negative influence on recurrence rates (P = 0.31). Although a positive family history predisposes a person to earlier onset of disease, recurrences occur within 5.1 +/- 6.2 years (mean +/- standard deviation) in patients with a positive family history and within 5.3 +/- 5.2 years in patients with a negative family history (P = 0.95).
Patients with a positive family history need closer surgical monitoring because primary disease will manifest earlier. A remarkable long-term recurrence rate exceeding 50% after 25 years places a much higher disease burden on patients with a positive family history. All available interventions known to reduce recurrence rate should be applied to this group of patients.
长期以来人们一直怀疑藏毛窦疾病家族史可能易导致更高的发病率。家族史对复发率的影响尚未得到研究。本研究的目的是评估有藏毛窦疾病个人史和家族史患者的复发率。
采用标准化电话访谈对1980年至1996年间接受初次手术的578例患者进行回顾性研究。使用Kaplan-Meier统计分析家族史阳性或阴性患者之间长期复发率的差异。
578例患者中有68例（12%）有一级亲属家族史阳性，其中28名兄弟和25名父亲有类似情况。家族史阳性时长期复发率显著升高（15年后分别为35%和22%，25年后分别为52%和28%；P = 0.02）。如果在较年轻时需要手术，长期复发率会升高（P = 0.03）。手术入院时测量的体重指数似乎对复发率没有任何负面影响（P = 0.31）。虽然家族史阳性使一个人易患更早发病，但家族史阳性患者的复发发生在5.1±6.2年（平均±标准差）内，家族史阴性患者的复发发生在5.3±5.2年（P = 0.95）。
家族史阳性的患者需要更密切的手术监测，因为原发性疾病会更早表现出来。25年后超过50%的显著长期复发率给家族史阳性的患者带来了更高的疾病负担。所有已知可降低复发率的可用干预措施都应应用于这组患者。
