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复发性骶尾部藏毛疾病的切开引流及刮除术

Unroofing and curettage for recurrent sacrococcygeal pilonidal disease.

作者信息

Koc Mehmet Ali, Celasin Haydar, Sunter Kaan, Akyol Cihangir, Gecim Ibrahim Ethem

机构信息

Department of Surgery, Ankara University School of Medicine, Ankara, Türkiye.

Department of Surgery, Lokman Hekim University School of Medicine, Ankara, Türkiye.

出版信息

Front Surg. 2024 Nov 20;11:1456846. doi: 10.3389/fsurg.2024.1456846. eCollection 2024.

DOI:10.3389/fsurg.2024.1456846
PMID:39634483
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11614795/
Abstract

PURPOSE

Sacrococcygeal pilonidal disease (SPD) is a global concern, notably in Southeast Europe and the Middle East. Unroofing curettage (UC), which provides faster recovery, better cosmetic appearance, and lower recurrence rates in the primary cases, was evaluated with the results of recurrent disease.

METHODS

This retrospective study included 74 patients with recurrent disease who were over 16 years of age, experienced recurrence after at least one surgical attempt, and underwent unroofing curettage between 2007 and 2019. Operation time, return to work duration, and recurrence rates were assessed.

RESULTS

Mean age of patients was 29.8 ± 10.6 years, and 61 (82.4%) were male. Previous procedures included excision + flap reconstruction, excision + primary closure, and local excision + lay open. Mean operation time for unroofing curettage was 22 ± 5.3 min. Mean durations for return to work and recovery were 5.9 ± 3 days, and 6.5 ± 2.6 weeks, respectively. Mean follow-up duration was 81.6 ± 49 months. Recurrence was only observed in 1 (1.3%) patient. Unroofing curettage showed a mean recurrence-free period of 156.9 months (95% CI [, 152.9-160.9 months).

CONCLUSION

Unroofing curettage stands out as a low-recurrence approach, likely to persist as a treatment method, especially for a selected group with recurrence.

摘要

目的

骶尾部藏毛窦疾病（SPD）是一个全球性问题，在东南欧和中东地区尤为突出。本研究对开放式刮除术（UC）治疗复发性疾病的效果进行评估，该术式在初发病例中具有恢复快、美容效果好和复发率低的特点。

方法

这项回顾性研究纳入了74例16岁以上的复发性疾病患者，这些患者至少经过一次手术治疗后复发，并于2007年至2019年间接受了开放式刮除术。评估手术时间、恢复工作时间和复发率。

结果

患者的平均年龄为29.8±10.6岁，其中61例（82.4%）为男性。既往手术方式包括切除+皮瓣重建、切除+一期缝合以及局部切除+敞开引流。开放式刮除术平均手术时间为22±5.3分钟。恢复工作和康复的平均时间分别为5.9±3天和6.5±2.6周。平均随访时间为81.6±49个月。仅1例（1.3%）患者复发。开放式刮除术的平均无复发期为156.9个月（95%CI[，152.9 - 160.9个月]）。

结论

开放式刮除术是一种低复发率的治疗方法，可能会继续作为一种治疗手段，特别是对于特定的复发患者群体。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/54a0/11614795/b8774a5e545e/fsurg-11-1456846-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/54a0/11614795/6f9f6b5ab2b8/fsurg-11-1456846-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/54a0/11614795/2edbe4a65a3d/fsurg-11-1456846-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/54a0/11614795/347e4f6c4197/fsurg-11-1456846-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/54a0/11614795/b8774a5e545e/fsurg-11-1456846-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/54a0/11614795/6f9f6b5ab2b8/fsurg-11-1456846-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/54a0/11614795/2edbe4a65a3d/fsurg-11-1456846-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/54a0/11614795/347e4f6c4197/fsurg-11-1456846-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/54a0/11614795/b8774a5e545e/fsurg-11-1456846-g004.jpg

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本文引用的文献

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Unroofing curettage for treatment of simple and complex sacrococcygeal pilonidal disease.开窗刮除术治疗单纯性和复杂性骶尾部藏毛疾病
Ann Surg Treat Res. 2022 Oct;103(4):244-251. doi: 10.4174/astr.2022.103.4.244. Epub 2022 Oct 7.
2
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Dis Colon Rectum. 2022 Oct 1;65(10):1241-1250. doi: 10.1097/DCR.0000000000002227. Epub 2022 May 24.
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Impact of geography and surgical approach on recurrence in global pilonidal sinus disease.
地理因素和手术方式对全球藏毛窦疾病复发的影响。
Sci Rep. 2019 Oct 22;9(1):15111. doi: 10.1038/s41598-019-51159-z.
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Outcomes of minimally invasive endoscopic pilonidal sinus surgery.微创内镜肛门窦切开术的结果。
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Colorectal Dis. 2018 Aug;20(8):O207-O214. doi: 10.1111/codi.14285. Epub 2018 Jun 27.
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Phenol Injection Versus Excision With Open Healing in Pilonidal Disease: A Prospective Randomized Trial.藏毛疾病中苯酚注射与开放愈合切除术的比较：一项前瞻性随机试验
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