Ankersen J L, Faurschou I K, Hougaard H T, Doll D, Oetzmann von Sochaczewski C, Sørensen M, Pedersen A G, Haas S
Department of Surgery, Randers Regional Hospital, Randers, Denmark.
International Pilonidal Research Group, Randers, Denmark.
Colorectal Dis. 2024 Sep 20;27(1). doi: 10.1111/codi.17169.
Pilonidal sinus disease (PSD) is a common condition. Despite a relatively large proportion of patients presenting as post-pubertal adolescents, only small cohorts focusing on this PSD subcategory have been published, and surgical treatment remains challenging.
The study is based on a prospective database established at Randers Regional Hospital in 2016. All patients undergoing Bascom's cleft lift (BCL) surgery from June 2016 until June 2020 were included in this study, focusing on patients ≤18 years of age comparing them to adult patients. Indications for BCL surgery were primary extensive manifestation, non-healing disease after previous elective surgery or disease recurrence.
In total, n = 380 PSD patients were operated, of which n = 79 were post-pubertal adolescents with a median age at time of surgery of 17.2 years (interquartile range 16.3, 18.0). Sixty-six (84%) were boys. Twenty-seven (34%) presented with primary extensive manifestation, 34 (43%) due to non-healing wounds and 18 (23%) due to recurrence. Fifty-four patients (69%) healed uneventfully. There was no difference between the indications of surgery groups in terms of overall healing or time to healing if prolonged (P = 0.6). The median follow-up was 62 months (interquartile range 48, 73), with a 5-year recurrence rate of 19%, compared to 17% (P = 0.6) in the adult population.
Our study is the first to investigate long-term clinical outcomes of BCL surgery for PSD in post-pubertal adolescent patients. Recurrences seem to occur more frequently compared to adults. However, we demonstrate that post-pubertal adolescent patients with advanced PSD can be treated with BCL surgery with acceptable outcomes.
藏毛窦疾病（PSD）是一种常见病症。尽管相当大比例的患者为青春期后青少年，但仅有少量关注该PSD亚类的队列研究发表，且手术治疗仍具有挑战性。
本研究基于2016年在兰讷斯地区医院建立的前瞻性数据库。纳入2016年6月至2020年6月期间所有接受巴斯科氏裂隙提升术（BCL）的患者，重点关注年龄≤18岁的患者，并与成年患者进行比较。BCL手术的指征为原发性广泛表现、既往择期手术后未愈合疾病或疾病复发。
总共380例PSD患者接受了手术，其中79例为青春期后青少年，手术时的中位年龄为17.2岁（四分位间距16.3，18.0）。66例（84%）为男性。27例（34%）表现为原发性广泛表现，34例（43%）因伤口未愈合，18例（23%）因复发。54例患者（占69%）顺利愈合。手术指征组在总体愈合情况或愈合时间延长方面无差异（P = 0.6）。中位随访时间为62个月（四分位间距48，73），5年复发率为19%，而成人人群为17%（P = 0.6）。
我们的研究首次调查了青春期后青少年患者PSD的BCL手术长期临床结果。与成年人相比，复发似乎更频繁。然而，我们证明青春期后患有晚期PSD的青少年患者可以接受BCL手术治疗，且结果可接受。
