Iesalnieks I, Deimel S, Schlitt H J
Klinik für Allgemein- und Viszeralchirurgie, Marienhospital Gelsenkirchen, Gelsenkirchen, Deutschland,
Chirurg. 2015 May;86(5):482-5. doi: 10.1007/s00104-014-2776-0.
Minimally invasive procedures have increasingly been used to treat pilonidal disease; however, the mid-term and long-term results have not been evaluated extensively yet.
All patients underwent "pit picking" surgery. The surgery was performed under local anesthesia. The technique of "pit picking" was: all midline pits were removed by excising a margin of skin of < 1 mm. An incision of 1 cm parallel to one side of the natal cleft opened the chronic abscess cavity. No specific postoperative wound care was given.
A total of 153 patients (126 males) underwent "pit picking" surgery between June 2007 and November 2010. Follow-up information was available for 148 patients (97 %). Of the patients 74% had no recurrence after a median follow-up time of 30 months and 8 more patients (5 %) remained asymptomatic after a second"pit picking" procedure. By multivariate analysis, smoking (hazard ratio [HR] 2.1) and occurrence of an abscess during the course of disease (HR 2.7) were statistically significantly associated with the disease recurrence after "pit picking" surgery.
Approximately three quarters of selected patients with pilonidal disease benefit from minimally invasive "pit picking" surgery.
微创手术越来越多地用于治疗藏毛窦疾病；然而，中期和长期结果尚未得到广泛评估。
所有患者均接受“挑坑”手术。手术在局部麻醉下进行。“挑坑”技术为：切除小于1毫米的皮肤边缘以去除所有中线坑。在与臀裂一侧平行处做一个1厘米的切口以打开慢性脓肿腔。术后未给予特殊伤口护理。
2007年6月至2010年11月期间，共有153例患者（126例男性）接受了“挑坑”手术。148例患者（97%）有随访信息。在这些患者中，74%在中位随访时间30个月后无复发，另有8例患者（5%）在第二次“挑坑”手术后仍无症状。多因素分析显示，吸烟（风险比[HR]2.1）和病程中出现脓肿（HR 2.7）与“挑坑”手术后疾病复发在统计学上显著相关。
大约四分之三选定的藏毛窦疾病患者从微创“挑坑”手术中获益。
