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激光消融术有效且显著地治疗藏毛窦疾病。

An effective and considerable treatment of pilonidal sinus disease by laser ablation.

机构信息

Department of Coloproctology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437, China.

出版信息

Lasers Med Sci. 2023 Mar 1;38(1):82. doi: 10.1007/s10103-023-03741-1.

Abstract

The treatment of sacrococcygeal pilonidal disease (SPD) is still challenging. Although many non-surgical and surgical methods exist, no consensus has been reached on the best treatment. This study aimed to evaluate the efficacy of laser ablation using 1470-nm radial diode laser fiber in treating SPD. We retrospectively studied the data of our 48 patients who operated on this technique between March 2019 and July 2022. All patients were treated with laser ablation using 1470-nm radial diode laser fiber. The healing rate and recurrence rate, demographic and surgical data, postoperative pain, complications (wound infection, wound bleeding), the time of returning to regular work and life, and the time of wound healing were recorded. Postoperative pain was measured based on the visual analog scale (VAS) score. Postoperative follow-up was performed in the outpatient clinic every 1 week for 1 month. Among the 48 patients, 41 males and 7 females, with a mean age of 27.7 years (range 14-42), the healing rate was 100%, and the average healing time was 28.3 ± 5.5 days. Mean operative time was 15.5 ± 3.3 min. The recurrence rate was 2.1%. One patient relapsed 3 months after the operation. The patient underwent laser ablation again, and the sinus tract was closed. The median visual analog scale (VAS) score on the day of operation was 0(0,2). The median VAS score on the first, third, seventh, and fourteenth day after operation was 0(0,2), 0(0,1), 0(0,1), and 0(0,0), respectively. There was no wound infection or bleeding after the operation. The mean time to normal work/life was 7.1 ± 3.2 days. Almost all the patients felt very satisfied with the operation. Laser ablation using 1470-nm radial diode laser fiber is effective in SPD treatment. It is associated with minor wounds and mild postoperative pain. It is a simple, safe, and minimally invasive technique and its clinical application for acute and chronic SPD in the absence of abscess is promising.

摘要

骶尾部藏毛窦病(SPD)的治疗仍然具有挑战性。尽管存在许多非手术和手术方法,但尚未就最佳治疗方法达成共识。本研究旨在评估 1470nm 径向二极管激光光纤激光消融治疗 SPD 的疗效。我们回顾性研究了 2019 年 3 月至 2022 年 7 月期间采用该技术治疗的 48 例患者的数据。所有患者均采用 1470nm 径向二极管激光光纤进行激光消融治疗。记录愈合率和复发率、人口统计学和手术数据、术后疼痛、并发症(伤口感染、伤口出血)、恢复正常工作和生活的时间以及伤口愈合时间。术后疼痛采用视觉模拟评分(VAS)评分进行测量。术后 1 个月每周在门诊进行随访。48 例患者中,男 41 例,女 7 例,年龄 14-42 岁,平均年龄 27.7 岁,愈合率 100%,平均愈合时间 28.3±5.5 天。平均手术时间为 15.5±3.3 分钟。复发率为 2.1%。1 例患者术后 3 个月复发。患者再次接受激光消融治疗,窦道闭合。术后当天 VAS 中位数为 0(0,2)。术后第 1、3、7、14 天的 VAS 中位数分别为 0(0,2)、0(0,1)、0(0,1)和 0(0,0)。术后无伤口感染或出血。恢复正常工作/生活的平均时间为 7.1±3.2 天。几乎所有患者对手术都非常满意。1470nm 径向二极管激光光纤激光消融治疗 SPD 有效。它的伤口较小,术后疼痛较轻。它是一种简单、安全、微创的技术,在无脓肿的急性和慢性 SPD 情况下具有广阔的临床应用前景。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aefb/9977879/9696189c366b/10103_2023_3741_Fig1_HTML.jpg

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