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整块切除臀沟藏毛窦及其窦道和汗腺区域并一期修复治疗该病

Excision of the Gluteal Cleft Pilonidal Sinus, Its Track, and the Sudoriferous Gland Area En-bloc with Primary Repair in the Management of this Disease.

作者信息

Hamza Muhammad, Ahmed Nadeem Irfan, Yasmeen Tahira, Fatima Noor

机构信息

Surgery, Al Noor Surgery Hospital, Chakwal, PAK.

Gynecology and Obstetrics, Holy Family Hospital, Rawalpindi, PAK.

出版信息

Cureus. 2018 Jun 14;10(6):e2806. doi: 10.7759/cureus.2806.

DOI:10.7759/cureus.2806
PMID:30123728
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6093273/
Abstract

Introduction Pilonidal disease is a common disease mostly affecting young males with a significant reduction in their working capabilities, hence, ideal and simple management of this disease is very important. Our study objective was to assess the recurrence rate of pilonidal sinus disease in patients with a complete excision of the pilonidal sinus, its track, and the sudoriferous gland area en-bloc with primary repair. Methods This descriptive study was conducted at Al-Noor Surgery, Chakwal, Pakistan, from February 2015 to July 2017. All patients who presented with acute and chronic pilonidal disease in the natal cleft, irrespective of age and gender, were included. We excluded from the study patients who had asymptomatic or recurrent pilonidal disease, previous pilonidal surgery, patients belonging to American Society of Anesthesiologists (ASA) Class III or above, immunodeficient patients, patients having bleeding disorders, patients on chemotherapy, and those diagnosed with comorbidities, e.g., anemia, tuberculosis, diabetes, and liver disease. Data were analyzed using Statistical Package for the Social Sciences (SPSS) version 21 (IBM Corp., Armonk, NY, US). Results During the study period, a total of one 112 patients were included. The male-to-female ratio was 55:1. The most common age group was the 21-25 age group. Chronic pilonidal disease was the most common presentation. Mean operative time was 22.09±3.65 minutes. There were no complications like bleeding, hematoma, edema, infection, and wound dehiscence. There was no recurrence in the six months follow-up. Hospital stay was 3.13±0.62 hours. Conclusion Simple excision of acute and chronic pilonidal sinus, its track, and the linked sudoriferous gland area en-bloc, followed by primary repair, is an effective approach to deal with this pathology.

摘要

引言

藏毛窦疾病是一种常见疾病,主要影响年轻男性,会显著降低他们的工作能力,因此,对这种疾病进行理想且简单的治疗非常重要。我们的研究目的是评估在完整切除藏毛窦及其窦道和汗腺区域并进行一期缝合的患者中,藏毛窦疾病的复发率。

方法

这项描述性研究于2015年2月至2017年7月在巴基斯坦查克拉尔的努尔外科进行。所有在臀裂处患有急性和慢性藏毛窦疾病的患者,无论年龄和性别,均被纳入研究。我们将无症状或复发性藏毛窦疾病患者、既往有藏毛窦手术史的患者、美国麻醉医师协会(ASA)分级为III级或以上的患者、免疫缺陷患者、有出血性疾病的患者、接受化疗的患者以及被诊断患有合并症(如贫血、结核病、糖尿病和肝病)的患者排除在研究之外。使用社会科学统计软件包(SPSS)21版(美国纽约州阿蒙克市IBM公司)进行数据分析。

结果

在研究期间,共纳入112例患者。男女比例为55:1。最常见的年龄组是21 - 25岁年龄组。慢性藏毛窦疾病是最常见的表现形式。平均手术时间为22.09±3.65分钟。没有出现出血、血肿、水肿、感染和伤口裂开等并发症。在六个月的随访中没有复发情况。住院时间为3.13±0.62小时。

结论

对急性和慢性藏毛窦及其窦道和相连的汗腺区域进行整块简单切除,然后进行一期缝合,是处理这种病理情况的有效方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/20fe/6093273/15640c95ec3d/cureus-0010-00000002806-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/20fe/6093273/15640c95ec3d/cureus-0010-00000002806-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/20fe/6093273/15640c95ec3d/cureus-0010-00000002806-i01.jpg

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本文引用的文献

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A New Surgical Technique for Closure of Pilonidal Sinus Defects: Triangular Closure Technique.一种用于闭合藏毛窦缺损的新手术技术:三角形闭合技术。
Med Sci Monit. 2017 Feb 26;23:1033-1042. doi: 10.12659/msm.899879.
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Semi-closed surgical technique for treatment of pilonidal sinus disease.用于治疗藏毛窦疾病的半封闭手术技术。
Ann Med Surg (Lond). 2017 Feb 10;15:47-51. doi: 10.1016/j.amsu.2017.02.004. eCollection 2017 Mar.
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Modified Primary Closure Method for the Treatment of Pilonidal Sinus.改良一期缝合术治疗藏毛窦
Eurasian J Med. 2016 Jun;48(2):84-9. doi: 10.5152/eurasianjmed.2015.0059.
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Modified Limberg's flap versus primary closure for treatment of pilonidal sinus disease: a comparative study.改良Limberg皮瓣术与一期缝合治疗藏毛窦疾病的比较研究
J Pak Med Assoc. 2014 Nov;64(11):1270-3.
5
A new approach: oblique excision and primary closure in the management of acute pilonidal disease.一种新方法:急性藏毛疾病治疗中的斜行切除与一期缝合。
Int J Clin Exp Med. 2014 Dec 15;7(12):5706-10. eCollection 2014.
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Pilonidal sinus disease: risk factors for postoperative complications and recurrence.藏毛窦疾病:术后并发症及复发的危险因素
Int Surg. 2012 Jul-Sep;97(3):224-9. doi: 10.9738/CC86.1.
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Pilonidal disease.藏毛疾病
Clin Colon Rectal Surg. 2011 Mar;24(1):46-53. doi: 10.1055/s-0031-1272823.
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Ambulatory treatment of chronic pilonidal sinuses with lateral incision and primary suture.门诊治疗慢性藏毛窦的侧切开术和一期缝合术。
Can J Surg. 2011 Apr;54(2):78-82. doi: 10.1503/cjs.026309.
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Excision with or without primary closure for pilonidal sinus disease.藏毛窦疾病的切除手术,可选择一期缝合或不缝合。
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