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单侧筋膜皮瓣 V-Y 推进术与切开挂线术治疗复发性藏毛窦的对比:一项回顾性临床研究。

Comparison of Unilateral Fasciocutaneous V-Y Flap Technique with Cleft Lift Procedure in the Treatment of Recurrent Pilonidal Sinus Disease: A Retrospective Clinical Study.

机构信息

Department of General Surgery, Suleyman Demirel University, School of Medicine,, Isparta, Turkey.

Department of General Surgery, Suleyman Demirel University, School of Medicine, Isparta, Turkey.

出版信息

Med Sci Monit. 2018 Feb 4;24:711-717. doi: 10.12659/msm.907398.

DOI:10.12659/msm.907398
PMID:29397396
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5808114/
Abstract

BACKGROUND This study aimed to assess treatment outcomes of the cleft lift procedure and V-Y flap technique in the treatment of recurrent pilonidal sinus disease (PSD). MATERIAL AND METHODS A total of 51 patients who underwent cleft lift procedure and 43 patients who underwent fasciocutaneous V-Y flap technique were evaluated. The demographic characteristics, previous operations, duration of symptoms, perioperative complications, duration of operation and hospital stay, duration of draining of all patients, and recurrence of PSD were recorded. RESULTS The mean operation time was 35.61±5.254 min in the cleft lift group (CLG) and 57.42±7.327 min in the V-Y flap group (VYFG) (p=0.001). No wound dehiscence was found in the VYFG and 5 patients (9.8%) had wound dehiscence in the CLG (p=0.035). Draining time was 1.39±0.603 days in the CLG and 2.79±0.638 days in VYFG (p=0.001). The mean hospital stay was 1.75±0.523 days in the CLG and 3.77±1.02 days in the VYFG (p=0.001). Two patients (3.9%) in the CLG had recurrence and no recurrence was reported in the VYFG (p=0.189) in the given time interval. CONCLUSIONS Both methods in treatment of recurrent PSD can be preferred because of low complication and recurrence rates. Because no recurrence was found after the V-Y flap technique, it appears to be a preferable method despite some disadvantages.

摘要

背景

本研究旨在评估切开挂线术和 V-Y 皮瓣技术治疗复发性藏毛窦疾病(PSD)的治疗效果。

材料和方法

共评估了 51 例行切开挂线术和 43 例行筋膜皮瓣 V-Y 成形术的患者。记录了患者的人口统计学特征、既往手术史、症状持续时间、围手术期并发症、手术时间和住院时间、所有患者引流时间以及 PSD 复发情况。

结果

切开挂线组(CLG)的平均手术时间为 35.61±5.254 分钟,V-Y 皮瓣组(VYFG)为 57.42±7.327 分钟(p=0.001)。VYFG 组无伤口裂开,CLG 组有 5 例(9.8%)发生伤口裂开(p=0.035)。CLG 的引流时间为 1.39±0.603 天,VYFG 为 2.79±0.638 天(p=0.001)。CLG 的平均住院时间为 1.75±0.523 天,VYFG 为 3.77±1.02 天(p=0.001)。CLG 中有 2 例(3.9%)复发,在给定的时间间隔内,VYFG 无复发(p=0.189)。

结论

两种方法治疗复发性 PSD 均可优先选择,因为它们的并发症和复发率都较低。由于 V-Y 皮瓣技术后未发现复发,尽管存在一些缺点,但它似乎是一种更可取的方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d432/5808114/1cab92386091/medscimonit-24-711-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d432/5808114/86231703717a/medscimonit-24-711-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d432/5808114/f06c7cdf245b/medscimonit-24-711-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d432/5808114/1cab92386091/medscimonit-24-711-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d432/5808114/86231703717a/medscimonit-24-711-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d432/5808114/f06c7cdf245b/medscimonit-24-711-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d432/5808114/1cab92386091/medscimonit-24-711-g003.jpg

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本文引用的文献

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Indian J Pediatr. 2017 Feb;84(2):134-138. doi: 10.1007/s12098-016-2180-5. Epub 2016 Jun 15.
2
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Asian J Surg. 2017 May;40(3):197-202. doi: 10.1016/j.asjsur.2015.10.002. Epub 2015 Nov 24.
3
Cleft lift procedure for pilonidal disease: technique and perioperative management.
藏毛窦疾病的臀沟提升手术:技术与围手术期管理
Tech Coloproctol. 2015 Aug;19(8):477-82. doi: 10.1007/s10151-015-1333-2. Epub 2015 Jul 14.
4
Application of fasciocutaneous V-Y advancement flap in primary and recurrent sacrococcygeal pilonidal sinus disease.筋膜皮V-Y推进皮瓣在原发性和复发性骶尾部藏毛窦疾病中的应用
Med Sci Monit. 2014 Jul 21;20:1263-6. doi: 10.12659/MSM.890752.
5
Modification of the Bascom cleft lift procedure for chronic pilonidal sinus: results in 141 patients.改良 Bascom 切开术治疗慢性藏毛窦:141 例患者的结果。
Colorectal Dis. 2013 Jul;15(7):e402-6. doi: 10.1111/codi.12243.
6
Cleft lift procedure for sacrococcygeal pilonidal disease.骶尾部藏毛窦疾病的臀沟提升术
Dis Colon Rectum. 2009 Jan;52(1):135-9. doi: 10.1007/DCR.0b013e31819734f8.
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Clinical experience with the hatchet-shaped gluteus maximus musculocutaneous flap.斧形臀大肌肌皮瓣的临床经验
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Pilonidal cyst: cause and treatment.藏毛窦:病因与治疗
Dis Colon Rectum. 2000 Aug;43(8):1146-56. doi: 10.1007/BF02236564.
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Br J Surg. 2000 Aug;87(8):1067-70. doi: 10.1046/j.1365-2168.2000.01472.x.
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