Halleran Devin R, Lopez Joseph J, Lawrence Amy E, Sebastião Yuri V, Fischer Beth A, Cooper Jennifer N, Deans Katherine J, Minneci Peter C
Center for Surgical Outcomes Research, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio; Department of Pediatric Surgery, Nationwide Children's Hospital, Columbus, Ohio.
Center for Surgical Outcomes Research, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio.
J Surg Res. 2018 Dec;232:430-436. doi: 10.1016/j.jss.2018.06.071. Epub 2018 Jul 21.
Recurrence rates of pilonidal disease have been reported to be high as 30%. Patients with recurrent pilonidal disease often develop chronic wounds and draining sinuses that incur long-term morbidity, disability, and decreased quality of life. The aim of this study was to characterize rates of recurrence in patients with pilonidal disease treated by pediatric surgeons.
A single center retrospective review of patients with pilonidal disease evaluated by pediatric surgeons from 2010 to 2015 was performed. Recurrence of pilonidal disease was defined as an episode of active pilonidal disease that required medical or surgical intervention >30 days from the preceding treatment. Repeated events proportional hazards regression modeling was performed to identify factors associated with time to recurrence.
Among 307 patients treated for pilonidal disease, nearly 50% were male, and the median age at initial evaluation was 16 years (IQR 15-17). Approximately 45% were obese (BMI ≥ 95th percentile). The initial treatment during the study period was surgical excision in two-thirds and incision and drainage and/or antibiotics in one-third. The overall recurrence rate was 33%, with the majority of recurrences (80%) occurring within the first year. On multivariable analysis, obese BMI was the only factor independently associated with time to disease recurrence.
Pilonidal disease has a substantial recurrence rate even after surgical excision. Future studies investigating treatments that can prevent disease recurrence are needed.
藏毛窦疾病的复发率据报道高达30%。复发性藏毛窦疾病患者常出现慢性伤口和引流窦道，导致长期发病、残疾和生活质量下降。本研究的目的是描述小儿外科医生治疗的藏毛窦疾病患者的复发率。
对2010年至2015年由小儿外科医生评估的藏毛窦疾病患者进行单中心回顾性研究。藏毛窦疾病的复发定义为在前次治疗>30天后需要药物或手术干预的活动性藏毛窦疾病发作。进行重复事件比例风险回归建模以确定与复发时间相关的因素。
在307例接受藏毛窦疾病治疗的患者中，近50%为男性，初次评估时的中位年龄为16岁（四分位间距15 - 17岁）。约45%为肥胖患者（BMI≥第95百分位数）。研究期间的初始治疗，三分之二为手术切除，三分之一为切开引流和/或使用抗生素。总体复发率为33%，大多数复发（80%）发生在第一年内。多变量分析显示，肥胖的BMI是与疾病复发时间独立相关的唯一因素。
即使手术切除后，藏毛窦疾病仍有较高的复发率。需要开展进一步研究以探寻能够预防疾病复发的治疗方法。
