用于治疗藏毛窦疾病的挖除术与Limberg皮瓣术及一期开放法——327例连续患者队列研究
Pit picking vs. Limberg flap vs. primary open method to treat pilonidal sinus disease - A cohort of 327 consecutive patients.
作者信息
Doll Dietrich, Petersen Sven, Andreae Octavia Alexandra, Matner Hanne, Albrecht Henning, Brügger Lukas E, Luedi Markus M, Puhl Gero
机构信息
Department of Procto-Surgery, St. Marienhospital Vechta, Academic Teaching Hospital of the MHH Hannover, Vechta, Germany.
Pilonidal Research Group, Vechta, Germany.
出版信息
Innov Surg Sci. 2022 Jun 27;7(1):23-29. doi: 10.1515/iss-2021-0041. eCollection 2022 Mar 1.
BACKGROUND
Minimally invasive methods in pilonidal sinus disease (PSD) surgery are becoming standard. Although long-term results are available for some techniques, long-term outcome data of patients after pit picking is lacking. We aimed at investigating perioperative and long-term outcomes of patients undergoing pit picking, Limberg flap or primary open surgery to treat PSD.
METHODS
In a single-centre observational study, we evaluated the outcomes of 327 consecutive patients undergoing PSD surgery between 2011 and 2020.
RESULTS
PSD had recurred in 22% of Limberg flap patients and 62% of pit picking patients at 5 years (p=0.0078; log rank test). Previous pilonidal surgeries, smoking, body mass index, immunodeficiency, and diabetes did not significantly influence the long-term recurrence rate. Primary open treatment was performed for 72% of female patients presenting with primary disease.
CONCLUSIONS
Due to its especially dismal long-term results, pit picking should be abandoned, and Limberg flap should be promoted instead, even for primary disease and in females.
背景
藏毛窦疾病（PSD）手术中的微创方法正逐渐成为标准术式。尽管某些技术已有长期疗效数据，但缺乏患者在挑痘术后的长期结局数据。我们旨在研究接受挑痘术、Limberg皮瓣术或一期开放手术治疗PSD患者的围手术期和长期结局。
方法
在一项单中心观察性研究中，我们评估了2011年至2020年间连续327例接受PSD手术患者的结局。
结果
5年时，Limberg皮瓣术患者中有22%复发，挑痘术患者中有62%复发（p = 0.0078；对数秩检验）。既往藏毛窦手术、吸烟、体重指数、免疫缺陷和糖尿病对长期复发率无显著影响。72%患有原发性疾病的女性患者接受了一期开放治疗。
结论
由于挑痘术尤其糟糕的长期疗效，应摒弃该术式，而应推广Limberg皮瓣术，即使是针对原发性疾病和女性患者。
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