鼻窦激光辅助闭合术（SiLaC®）治疗藏毛窦疾病：一项多中心队列研究的结果。

Sinus laser-assisted closure (SiLaC®) for pilonidal disease: results of a multicentre cohort study.

机构信息

Department of Surgery, Flevoziekenhuis, 1 Hospitaalweg, 1315 RA, Almere, The Netherlands.

Department of Surgery, Albert Schweitzer Hospital, Dordrecht, The Netherlands.

出版信息

Tech Coloproctol. 2022 Feb;26(2):135-141. doi: 10.1007/s10151-021-02550-4. Epub 2022 Jan 7.

DOI:10.1007/s10151-021-02550-4

PMID:34993686

Abstract

BACKGROUND

An emerging and promising minimally invasive treatment for pilonidal disease (PD) is sinus laser-assisted closure (SiLaC®). Previous studies have shown encouraging results concerning safety, patient satisfaction, wound healing and acceptable recurrence rates. This study investigated outcomes for a large cohort of PD patients treated with SiLaC®.

METHODS

A multicentre cohort study with a prospective design and partial retrospective data collection for patients with PD treated with SiLaC® in three hospitals in the Netherlands (Albert Schweitzer Hospital, Flevoziekenhuis and Medical Centre Zuiderzee) from January 1st 2017 to March 1st 2020. The primary outcome was recurrence. Secondary outcomes were incidence of complete wound closure, time until wound closure, postoperative complications, ability to perform daily activities and reported patient satisfaction.

RESULTS

A total of 311 patients were included with a median follow-up of 10 months (range 1-52 months). The recurrence rate after one SiLaC® treatment was 26% with 7% experiencing incomplete wound closure, resulting in an initial success rate of 66% after one SiLaC® procedure. This increased to 92% and 98% after two and three SiLaC® procedures, respectively. Mean time until wound closure was 6 weeks (range 1-24 weeks). Seven patients (2%) were still unsuccessfully treated after three SiLaC® treatments and required additional and extensive surgery. Mean time to perform regular daily activities including working was 6 days (range 0-42 days) and the vast majority of patients (84%) did not require painkillers or only paracetamol. Twelve patients (4%) developed a postoperative wound infection. The mean satisfaction score was 9 (range 5-10).

CONCLUSIONS

SiLaC® is a promising minimally invasive treatment for PD with high patient satisfaction and an acceptable success rate. These results suggest that SiLaC® could be used as a safe and effective primary treatment for PD.

摘要

背景

对于藏毛窦病（PD），一种新兴且有前途的微创治疗方法是窦激光辅助闭合术（SiLaC®）。先前的研究表明，该方法在安全性、患者满意度、伤口愈合和可接受的复发率方面有令人鼓舞的结果。本研究调查了在荷兰三家医院（Albert Schweitzer 医院、Flevoziekenhuis 和 Medical Centre Zuiderzee）接受 SiLaC®治疗的大量 PD 患者的结果。

方法

这是一项多中心队列研究，设计前瞻性，部分数据回顾性，纳入了 2017 年 1 月 1 日至 2020 年 3 月 1 日期间在荷兰三家医院（Albert Schweitzer 医院、Flevoziekenhuis 和 Medical Centre Zuiderzee）接受 SiLaC®治疗的 PD 患者。主要结局是复发。次要结局是完全伤口闭合的发生率、伤口闭合时间、术后并发症、日常活动能力和报告的患者满意度。

结果

共纳入 311 例患者，中位随访时间为 10 个月（范围 1-52 个月）。单次 SiLaC®治疗后复发率为 26%，7%患者出现不完全伤口闭合，因此单次 SiLaC®手术后的初始成功率为 66%。两次和三次 SiLaC®手术后，分别增加到 92%和 98%。伤口闭合时间平均为 6 周（范围 1-24 周）。7 例（2%）患者在三次 SiLaC®治疗后仍未得到成功治疗，需要额外的广泛手术。常规日常活动（包括工作）的平均恢复时间为 6 天（范围 0-42 天），绝大多数患者（84%）无需服用止痛药或仅需服用扑热息痛。12 例（4%）患者发生术后伤口感染。平均满意度评分为 9 分（范围 5-10 分）。