Department of Surgery, Clinic of Visceral and Thoracic Surgery, Cantonal Hospital Winterthur, 8400 Winterthur, Zurich, Switzerland.
Department of Pediatric Surgery, University Children's Hospital of Basel, 4056 Basel, Switzerland.
Medicina (Kaunas). 2020 Jul 9;56(7):341. doi: 10.3390/medicina56070341.
: No current nationwide consensus exists on pilonidal disease (PD) treatment in Switzerland and Austria. The objective of this study was to assess and compare the spectrum of PD treatment strategies in Switzerland and Austria. : A survey including 196 certified institutions (Switzerland, = 99 and Austria, = 97) was performed. Treatment strategies for both chronic and acute pilonidal disease were investigated, as well as evolution of treatment over the last 20 years. : In total, 92 of 196 (47%) hospitals participated in the survey. Recurrence rate (20%) was similar between the two countries. In acute pilonidal disease, a two-stage approach with incision and drainage as the first step was preferred over a one-stage procedure in both countries. In Austria, all patients with chronic pilonidal disease were treated as inpatients, whereas 28% of patients in Switzerland were treated on an outpatient basis ( = 0.0019). Median length of hospital stay was double in Austria (four days) compared to Switzerland (two days; < 0.001). Primary resection and off-midline closure ( = 0.017) and the use of tissue flaps ( = 0.023) were performed more commonly in Austria than in Switzerland. Minimally invasive techniques were performed more often in Switzerland than in Austria (52% vs. 4%, < 0.001). Overall, wide excision with secondary wound healing or midline closures declined over the last 20 years. : Treatment strategies for chronic PD differ between Austria and Switzerland with more and longer inpatient care in Austria, increasingly minimally invasive approaches in Switzerland, and outdated procedures still being performed in both countries. Overall, heterogeneity of practice dominates in both countries.
目前瑞士和奥地利在藏毛窦疾病（PD）的治疗上没有达成全国共识。本研究的目的是评估和比较瑞士和奥地利 PD 治疗策略的范围。
我们进行了一项包括 196 家认证机构（瑞士， = 99 家；奥地利， = 97 家）的调查。调查了慢性和急性藏毛窦疾病的治疗策略，以及过去 20 年治疗方法的演变。
总共有 196 家医院中的 92 家（47%）参与了调查。两国的复发率（20%）相似。在急性藏毛窦疾病中，两国均首选两步法（切开引流作为第一步），而不是一步法。在奥地利，所有慢性藏毛窦疾病患者均住院治疗，而瑞士则有 28%的患者门诊治疗（ = 0.0019）。奥地利的住院时间中位数为四天，而瑞士为两天（ < 0.001）。奥地利更常进行原发切除和偏离中线的缝合（ = 0.017）和使用组织瓣（ = 0.023），而瑞士更常进行微创手术（52%比 4%， < 0.001）。
总体而言，过去 20 年来，广泛切除加二期愈合或中线闭合的方法减少了。
瑞士和奥地利治疗慢性 PD 的策略不同，奥地利的住院治疗更多、时间更长，瑞士则更多采用微创方法，两国仍在使用过时的方法。总的来说，两国的实践差异很大。
