Oliveira Ana Isabel, Barroso Catarina, Osório Angélica, Correia-Pinto Jorge
Department of Pediatric Surgery, Hospital de Braga, Braga, Portugal.
School of Medicine, Life and Health Sciences Research Institute (ICVS), University of Minho, Braga, Portugal.
Front Pediatr. 2019 Jun 4;7:215. doi: 10.3389/fped.2019.00215. eCollection 2019.
Sacrococcygeal Pilonidal Disease (PD) is commonly treated with excision and primary closure techniques (EPC). Minimally invasive techniques (MIT), such as EPSiT and , had been recently advocated promising better outcomes. We analyzed mid-term results from our center after introduction of MIT to treat PD. Patients submitted to MIT ( = 44) with a median follow-up of 37 months were analyzed and compared with patients submitted to EPC ( = 70) with a median follow-up of 5 years. Both groups included patients operated in our department between 2011 and 2016 and have similar demographic and clinical characteristics. We compared operative time and post-operative parameters such as time with pain, dressing time and time to relapse. The post-operative time with pain was significantly lower, whereas the dressing time was significantly longer, in MIT when compared to the EPC group. The relapse rate was similar in both groups but the follow-up is shorter in the MIT group. In addition, the analysis of patients free of disease using Kaplan-Meier curves revealed that relapse tends to occur more precociously in MIT than in EPC patients ( = 0.014). Interestingly, in the subgroup of patients with previous surgery, MIT's relapse rate was significantly lower than in the EPC group (30 vs. 100%, < 0.001). MIT has the advantage of having a shorter time with pain in the postoperative period, while EPC benefits from a shorter dressing time. In general, the relapse of the disease tends to manifest more precociously in MIT patients. Moreover, in the subgroup of patients with previous surgery, MIT seems to have significantly better results when compared to EPC.
骶尾部藏毛窦疾病（PD）通常采用切除和一期缝合技术（EPC）进行治疗。最近有人提倡采用微创技术（MIT），如EPSiT等，有望取得更好的治疗效果。我们分析了本中心引入MIT治疗PD后的中期结果。对接受MIT治疗（n = 44）且中位随访时间为37个月的患者进行了分析，并与接受EPC治疗（n = 70）且中位随访时间为5年的患者进行了比较。两组均包括2011年至2016年在我科接受手术的患者，且具有相似的人口统计学和临床特征。我们比较了手术时间和术后参数，如疼痛时间、换药时间和复发时间。与EPC组相比，MIT组术后疼痛时间显著缩短，而换药时间显著延长。两组的复发率相似，但MIT组的随访时间较短。此外，使用Kaplan-Meier曲线对无疾病患者进行分析发现，MIT组的复发往往比EPC组患者更早出现（P = 0.014）。有趣的是，在既往接受过手术的患者亚组中，MIT组的复发率显著低于EPC组（30%对100%，P < 0.001）。MIT的优势在于术后疼痛时间较短，而EPC的优势在于换药时间较短。总体而言，该疾病的复发在MIT患者中往往更早出现。此外，在既往接受过手术的患者亚组中，与EPC相比，MIT似乎具有显著更好的治疗效果。
