采用标准化的治疗方案治疗藏毛窦疾病可降低其复发率。

Adoption of a standardized treatment protocol for pilonidal disease leads to low recurrence.

机构信息

Division of Pediatric Surgery, Department of Surgery, Stanford University, 453 Quarry Road, Palo Alto, CA 94304, United States.

出版信息

J Pediatr Surg. 2023 Mar;58(3):532-536. doi: 10.1016/j.jpedsurg.2022.06.014. Epub 2022 Jun 25.

DOI:10.1016/j.jpedsurg.2022.06.014

PMID:35868880

Abstract

BACKGROUND

Pilonidal disease may present as acute abscesses or chronic draining sinuses. There is no standardized treatment and recurrence rates can be as high as 30%. Within our five-hospital network we have established a standardized treatment protocol including minimally invasive surgical trephination and aggressive epilation. We hypothesize that such a treatment protocol can be established across different hospital settings and lead to low overall recurrence.

METHODS

Patients with pilonidal disease were enrolled in the study on presentation to our hospital network. Those that underwent initial surgery outside our hospital system or were noncompliant with our treatment protocol were excluded. Patients were grouped based on surgeon and treating facility. Frequency of recurrence per surgeon and per hospital was calculated and compared.

RESULTS

Out of 132 patients, 80 patients were included (45 female, 35 male) while 52 were excluded because of initial surgery at a non-network hospital or for protocol noncompliance. Median age was 17 (16-19) years and median length of follow-up was 352 (261-496) days. There were 6 patients who experienced at least one recurrence. There was an overall 8% recurrence rate with no significant difference noted between surgeons or hospitals (p = 0.15, p = 0.64, respectively).

CONCLUSIONS

We have successfully implemented a standardized treatment protocol for pilonidal disease across different hospital settings and by different surgeons, with an overall low recurrence rate. Our findings suggest that adoption of a standardized protocol for treatment of pilonidal disease can lead to low recurrence.

LEVEL OF EVIDENCE

Level IV.

摘要

背景

藏毛窦疾病可表现为急性脓肿或慢性窦道。目前尚无标准化的治疗方法，复发率高达 30%。在我们的五家医院网络中，我们建立了一个标准化的治疗方案，包括微创外科钻孔和积极的脱毛。我们假设这样的治疗方案可以在不同的医院环境中建立，并导致总体复发率低。

方法

患有藏毛窦疾病的患者在就诊于我们的医院网络时被纳入研究。那些在我们的医院系统之外接受初始手术或不遵守我们的治疗方案的患者被排除在外。根据外科医生和治疗机构对患者进行分组。计算并比较每位外科医生和每家医院的复发频率。

结果

在 132 名患者中，有 80 名患者（45 名女性，35 名男性）被纳入研究，而 52 名患者因在非网络医院接受初始手术或不遵守治疗方案而被排除在外。中位年龄为 17 岁（16-19 岁），中位随访时间为 352 天（261-496 天）。有 6 名患者至少经历过一次复发。总复发率为 8%，外科医生之间或医院之间无显著差异（p=0.15，p=0.64）。