Speter Chen, Zmora Osnat, Nadler Roy, Shinhar Daniel, Bilik Ron
Department of Pediatric Surgery, Sheba Medical Center, Tel Hashomer, Ramat Gan, 5265601, Israel.
Department of Pediatric Surgery, Sheba Medical Center, Tel Hashomer, Ramat Gan, 5265601, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 6997801, Israel.
J Pediatr Surg. 2017 Sep;52(9):1484-1487. doi: 10.1016/j.jpedsurg.2017.03.040. Epub 2017 Mar 20.
To evaluate functional and long-term outcome of a minimal incision technique for resection of pilonidal sinus in children.
All children who underwent surgery for pilonidal sinus in our institution between October 2008 and March 2015 were included. We performed a retrospective chart review and a follow-up telephone survey. Demographic, clinical and outcome data were compared between patients who underwent either minimal incision or wide excision surgery.
Study groups included 21 cases of minimal incision procedure and 21 cases of wide excision procedure with similar demographic and clinical characteristics. Postoperative functional outcome was significantly better in the minimal incision group with fewer days on analgesics (0 versus 2.5, P=0.005), fewer sick days (4 versus 14, P<0.001), and fewer days to full activity (10 versus 45, P<0.001). Reoperation rate was 28% for minimal incision and 9% for wide excision (P=0.238). Overall long-term favorable outcome (no reoperation/recurrent abscess/continued symptoms) rate was 62% after minimal incision and 45% after wide excision (P=0.354).
The minimal incision is a promising technique for resection of pilonidal sinus in children as it is associated with better postoperative functional outcome and comparable long-term outcome compared with wide excision.
Therapeutic study- level III.
评估儿童藏毛窦切除的微创技术的功能及长期疗效。
纳入2008年10月至2015年3月间在本机构接受藏毛窦手术的所有儿童。我们进行了回顾性病历审查及随访电话调查。对接受微创或广泛切除手术的患者的人口统计学、临床及疗效数据进行比较。
研究组包括21例微创病例和21例广泛切除病例，两组在人口统计学及临床特征方面相似。微创组术后功能结局显著更好，镇痛天数更少（0天对2.5天，P = 0.005），病假天数更少（4天对14天，P < 0.001），完全恢复活动的天数更少（10天对45天，P < 0.001）。微创组再次手术率为28%，广泛切除组为9%（P = 0.238）。微创术后总体长期良好结局（无再次手术/复发性脓肿/持续症状）率为62%，广泛切除术后为45%（P = 0.354）。
微创是一种有前景的儿童藏毛窦切除技术，因为与广泛切除相比，它术后功能结局更好，长期疗效相当。
治疗性研究 - III级。
