结晶苯酚在已手术治疗的复发性藏毛窦疾病的非手术治疗中的应用。

Crystallized phenol in nonoperative treatment of previously operated, recurrent pilonidal disease.

机构信息

Department of Surgery, Firat Euphrates University School of Medicine, Elazig, Turkey.

出版信息

Dis Colon Rectum. 2010 Jun;53(6):932-5. doi: 10.1007/DCR.0b013e3181d8283b.

DOI:10.1007/DCR.0b013e3181d8283b

PMID:20485008

Abstract

PURPOSE

Recurrence after surgery for pilonidal disease remains a challenge. We investigated the application of crystallized phenol as a nonoperative treatment for patients with recurrent, previously operated pilonidal disease.

METHODS

Participants were patients treated for recurrent pilonidal disease at our clinics from January 1995 through August 2007. Crystallized phenol was administered on an outpatient basis. Patient and disease characteristics including age, gender, body mass index, occupation, family history, time from previous operation to recurrence and to phenol treatment, number and type of previous operations, and characteristics of recurrent sinuses at entry were prospectively recorded. Outcome variables included number of phenol applications, recovery time, recurrence, and treatment success or failure.

RESULTS

A total of 36 patients with recurrent pilonidal disease were treated with crystallized phenol (mean recurrence time after previous surgery, 16.2 +/- 4.6 months; number of previous operations, 1.47 +/- 0.9). The mean number of phenol applications per patient was 3.7 +/- 1.3 (range, 1-7). No serious side effects were observed. Exfoliation of a 2-cm area around the sinus openings in 3 patients (8.3%) was easily treated with ointments locally; patients reported minimal pain. Healing was obtained in all patients in a median of 48 (range, 10-153) days. During follow-up (mean duration, 54.4 +/- 5.2 months; range, 29-169 months), 31 patients (86.1%) had no recurrence and 5 patients (13.9%) had recurrence. Recurrent sinuses were successfully treated by a second course of crystallized phenol in 2 patients, 1 patient refused retreatment, and healing was not obtained with a second treatment course in 2 patients, yielding an overall success rate of 91.7% and failure rate of 8.3%.

CONCLUSION

Crystallized phenol application is a simple, inexpensive nonoperative procedure that can be performed in an outpatient setting and is suitable for the treatment of previously operated recurrent pilonidal disease.

摘要

目的

皮瓣切开术后疾病复发仍然是一个挑战。我们研究了结晶苯酚作为非手术治疗复发性、既往手术治疗皮瓣切开术后疾病的应用。

方法

研究对象为 1995 年 1 月至 2007 年 8 月在我们诊所接受治疗的复发性皮瓣切开术后疾病患者。结晶苯酚在门诊进行治疗。前瞻性记录患者和疾病特征，包括年龄、性别、体重指数、职业、家族史、上次手术到复发和苯酚治疗的时间、上次手术的数量和类型、以及入组时复发性窦道的特征。结果变量包括苯酚应用的数量、恢复时间、复发和治疗成功或失败。

结果

36 例复发性皮瓣切开术后疾病患者接受结晶苯酚治疗（平均上次手术后复发时间为 16.2+/-4.6 个月；上次手术次数为 1.47+/-0.9）。每位患者平均应用苯酚 3.7+/-1.3 次（范围为 1-7 次）。未观察到严重的副作用。3 例（8.3%）患者的窦道开口周围 2cm 区域脱皮，用局部软膏很容易治疗；患者报告疼痛轻微。所有患者的中位愈合时间为 48（范围为 10-153）天。在随访期间（平均持续时间为 54.4+/-5.2 个月；范围为 29-169 个月），31 例（86.1%）患者无复发，5 例（13.9%）患者复发。2 例患者通过第二疗程结晶苯酚治疗成功治疗复发性窦道，1 例患者拒绝再次治疗，2 例患者第二疗程未获得愈合，总成功率为 91.7%，失败率为 8.3%。