Calikoglu Ismail, Gulpinar Kamil, Oztuna Derya, Elhan Atilla Halil, Dogru Osman, Akyol Cihangir, Erkek Bulent, Kuzu Mehmet Ayhan
1 Department of Surgery, Ankara University, Ankara, Turkey 2 Department of Surgery, Ufuk University, Ankara, Turkey 3 Department of Biostatistics, Ankara University, Ankara, Turkey 4 Department of Surgery, Konya Training and Research Hospital, Konya, Turkey.
Dis Colon Rectum. 2017 Feb;60(2):161-169. doi: 10.1097/DCR.0000000000000717.
Minimally invasive procedures may be an alternative to surgical excisions for pilonidal disease.
The aim of the study was to compare phenol injection versus excision with open healing technique.
This is a prospective randomized study (ACTRN12612000868886).
This study was conducted at the Ankara University and Ufuk University Departments of Surgery.
One hundred forty patients were randomly assigned to phenol injection (n = 70) or excision with open healing (n = 70).
The primary end point of the study was the time to complete wound healing. Secondary end points were visual analog scale pain score, painkiller intake, time to resume daily activities, recurrence rate, Short Form 36 Health Survey, and Nottingham Health Profile at 3 weeks after surgery.
Time to complete wound healing (16.2 ± 8.7 versus 40.1 ± 9.7 days) was significantly in favor of the phenol injection group (p < 0.001). The median operation time was 14.0 ± 3.8 minutes in the phenol group versus 49.0 ± 24.2 minutes in the excision with open healing group (p < 0.001). The time to resume daily activities (pain-free mobilization and defecation) was 0.8 ± 2.8 and 16.2 ± 12.6 hours after phenol injection and 9.3 ± 10.0 and 22.5 ± 15.1 hours after the excision with open healing treatment (p < 0.001, p = 0.008). Visual analog pain score at 48 hours and painkiller intake within 48 hours were significantly in favor of the phenol injection group. At the mean follow-up of 39.2 ± 9.0 months after surgery, no differences were seen in the recurrence rate between the treatment arms (13 recurrences in phenol vs 9 in excision with open healing; p = not significant). Short Form 36 and Nottingham Health Profile scores at 3 weeks after surgery were also in favor of phenol injection.
The present study was not double blinded, and a history of abscess drainage was significantly higher in the surgery group.
Based on the results, we conclude that phenol injection is as effective as the excision with open healing technique.
对于藏毛窦疾病，微创手术可能是手术切除的一种替代方法。
本研究旨在比较苯酚注射与开放愈合技术切除的效果。
这是一项前瞻性随机研究（澳大利亚新西兰临床试验注册号：ACTRN12612000868886）。
本研究在安卡拉大学和乌富克大学外科进行。
140例患者被随机分为苯酚注射组（n = 70）和开放愈合切除组（n = 70）。
本研究的主要终点是伤口完全愈合的时间。次要终点包括视觉模拟评分法疼痛评分、止痛药摄入量、恢复日常活动的时间、复发率、术后3周的简短健康调查问卷36项和诺丁汉健康量表。
伤口完全愈合时间（16.2 ± 8.7天对40.1 ± 9.7天）明显有利于苯酚注射组（p < 0.001）。苯酚组的中位手术时间为14.0 ± 3.8分钟，而开放愈合切除组为49.0 ± 24.2分钟（p < 0.001）。恢复日常活动（无痛活动和排便）的时间在苯酚注射后为0.8 ± 2.8小时和16.2 ± 12.6小时，在开放愈合切除治疗后为9.3 ± 10.0小时和22.5 ± 15.1小时（p < 0.001，p = 0.008）。48小时时的视觉模拟疼痛评分和48小时内的止痛药摄入量明显有利于苯酚注射组。在术后平均随访39.2 ± 9.0个月时，两组之间在复发率上没有差异（苯酚组13例复发，开放愈合切除组9例复发；p值无统计学意义）。术后3周的简短健康调查问卷36项和诺丁汉健康量表评分也有利于苯酚注射。
本研究并非双盲研究，且手术组脓肿引流史明显更高。
基于结果，我们得出结论，苯酚注射与开放愈合技术切除一样有效。
