Iacob Catalin, Niazov Eleonora, Zmora Osnat
Department of Pediatric Surgery, Shamir Medical Center, Be'er Ya'acov, Israel.
Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel.
Pediatr Surg Int. 2024 Dec 21;41(1):39. doi: 10.1007/s00383-024-05941-4.
Minimal incision procedures have been recommended for pediatric pilonidal sinus disease, based on small studies with short follow-up. We aimed to describe medium-term outcomes of trephination in a large cohort.
Retrospective chart review and additional concluding telephone interviews for all children who underwent primary trephination in our institution over 5.5 years, collecting demographic and clinical data, and updated functional and recurrence outcome data.
100 patients were included. Median follow-up time was 31.4 (16.2-52.8) months. Post-operative analgesics were used for 1.25 (0-4) days, sick days were 7 (3-11), and time to full activity was 14 (14-30) days. Recurrent pain, discharge, and abscess/es were reported by 37%, 35%, and 15% of patients, with 80-85% occurring within the first post-operative year. Reoperation rate was 18%, with 95% occurring within 2 years. No significant associations were found between demographic or clinical characteristics and either functional or recurrence medium-term outcomes.
Trephination carries excellent functional outcome with less favorable medium-term efficacy for the treatment of primary pediatric pilonidal sinus disease. Most adverse outcomes, including reoperations, occur within the first two years.
基于短期随访的小型研究，小儿藏毛窦疾病推荐采用微创术式。我们旨在描述一大群患儿经环钻引流术治疗后的中期疗效。
对我院5.5年期间所有接受初次环钻引流术的患儿进行回顾性病历审查，并通过电话随访获取最终结果，收集人口统计学和临床数据，以及最新的功能和复发结局数据。
纳入100例患者。中位随访时间为31.4（16.2 - 52.8）个月。术后使用镇痛药1.25（0 - 4）天，病假天数为7（3 - 11）天，恢复正常活动时间为14（14 - 30）天。37%、35%和15%的患者分别出现复发性疼痛、分泌物和脓肿，其中80 - 85%发生在术后第一年内。再次手术率为18%，95%在2年内发生。在人口统计学或临床特征与功能或复发中期结局之间未发现显著关联。
对于原发性小儿藏毛窦疾病的治疗，环钻引流术具有良好的功能结局，但中期疗效欠佳。大多数不良结局，包括再次手术，发生在头两年内。
