Huurman Eleonora A, de Raaff Christel A L, van den Berg Rosaline, Baart Sara J, Wijnhoven Bas P L, Schouten Ruben, Furnée Edgar J B, Smeenk Robert M, Toorenvliet Boudewijn R
Department of Surgical Oncology and Gastrointestinal Surgery, Erasmus MC Cancer Institute, Rotterdam, the Netherlands.
Department of Surgery, Albert Schweitzer Hospital, Dordrecht, the Netherlands.
Colorectal Dis. 2024 Dec 2. doi: 10.1111/codi.17217.
Managing pilonidal sinus disease (PSD) remains challenging due to high recurrence rates and morbidity associated with treatment. The aim of this study was to evaluate the outcomes one year after surgical treatment for chronic PSD in the Netherlands.
Patients with PSD who underwent surgical treatment between March 1, 2020, and March 1, 2021, at 36 participating hospitals were included in a prospective observational cohort study. For the present study, only patients with chronic PSD were included for analysis. One-year after surgical treatment for PSD, all patients received questionnaires on wound healing, quality of life (QoL), and patient reported experience measures (PREMs). Primary outcome was recurrence rate. Secondary outcomes included QoL and PREMs.
Of 681 included patients, 405 patients presented with chronic PSD and underwent surgical treatment. One-year questionnaires were completed by 289 out of 405 patients (71.4%). Patients underwent either excision with secondary wound healing (ESW, n = 73), excision with midline closure (EMC, n = 21), off-midline closure (OMC, n = 17), or a minimally invasive technique (MIT, n = 178). Patient-reported recurrence rates after ESW, EMC, OMC and MIT were 21.5%, 25%, 6.7% and 30.6%, respectively. Pain/discomfort and anxiety/depression were the most frequently reported problems affecting QoL. Patients that underwent OMC were satisfied the most with the care provided.
This study demonstrates variation in recurrence rates among surgical procedures for PSD. The highest rates were observed in the MIT and EMC group, while the OMC group exhibited the lowest rate. QoL outcomes differed among the surgical techniques. Patient satisfaction appears highest in the OMC group.
由于复发率高以及治疗相关的发病率，藏毛窦疾病（PSD）的管理仍然具有挑战性。本研究的目的是评估荷兰慢性PSD手术治疗一年后的结果。
2020年3月1日至2021年3月1日期间在36家参与研究的医院接受手术治疗的PSD患者被纳入一项前瞻性观察队列研究。对于本研究，仅纳入慢性PSD患者进行分析。PSD手术治疗一年后，所有患者均收到关于伤口愈合、生活质量（QoL）和患者报告体验指标（PREMs）的问卷。主要结局是复发率。次要结局包括QoL和PREMs。
在681名纳入患者中，405例患者患有慢性PSD并接受了手术治疗。405例患者中的289例（71.4%）完成了一年期问卷。患者接受了二期伤口愈合切除术（ESW，n = 73）、中线闭合切除术（EMC，n = 21）、非中线闭合术（OMC，n = 17）或微创技术（MIT，n = 178）。ESW、EMC、OMC和MIT后患者报告的复发率分别为21.5%、25%、6.7%和30.6%。疼痛/不适和焦虑/抑郁是影响QoL最常报告的问题。接受OMC的患者对所提供的护理满意度最高。
本研究表明PSD手术方法的复发率存在差异。MIT和EMC组的复发率最高，而OMC组的复发率最低。不同手术技术的QoL结果有所不同。OMC组的患者满意度似乎最高。
