Affiliation:
1. St Petersburg University
2. Military Medical Academy
3. City hospital № 40 of the Kurortny district
4. North-Western State Medical University named after I. I. Mechnikov
Abstract
The OBJECTIVE was to evaluate long-term results of the use of «closed» techniques of surgical treatment of pilonidal disease.METHODS AND MATERIALS. The study included 147 patients who underwent excision of the pilonidal sinuses according to Karydakis – 28 and excision of the pilonidal sinuses with mobilization of the gluteal fascia – 89, laser obliteration using Filac Fistula Probe – 30 patients. To assess the long-term results, a questionnaire survey of patients, a face-to-face examination and ultrasound of the soft tissues of the postoperative scar area, statistical data processing were carried out.RESULTS. By primary intention, wounds healed in 91.4 % of patients. Complications were observed in 10 (8.5 %) patients: postoperative wound seromas – 8, wound hematoma – 1, postoperative wound suppuration – 1. After mobilization of the gluteal fascia, recurrence of the disease was established in 4 (4.4 %) patients, after obliteration with the use of laser energy and Filac Fistula Probe – in 4 (13.3 %) patients. No relapse was diagnosed after Karydakis procedure.CONCLUSIONS. Operations using «closed» techniques are effective methods of surgical treatment of pilonidal disease. At the same time, there is a low percentage of complications, relapses of the disease and a short period of rehabilitation.
Publisher
FSBEI HE I.P. Pavlov SPbSMU MOH Russia
Reference13 articles.
1. Clinical recommendations. Coloproctology / eds by Yu. A. Shelygina. Moscow, GEHOTAR-Media, 2015:528. (In Russ.).
2. Duman K., Gırgın M., Harlak A. Prevalence of sacrococcygeal pilonidal disease in Turkey // Asian Journal of Surgery. 2017;(40):434–437. Doi: 10.1016/j.asjsur.2016.04.001.
3. Johnson E., Vogel J., Cowan M. et al. The American Society of Colon and rectal surgeons clinical practice guidelines for the management of Pilonidal Disease // Dis Colon rectum. 2019;62(2):146–157. Doi: 10.1097/dcr.0000000000001237
4. Lurin I. A., Tsema Ie. V. Aetiology and pathogenesis of pilonidal disease (review article) // Coloproctology. 2013;(3):35–49. (In Russ.).
5. Titov A. Yu., Kostarev I. V., Batischev A. K. Etiopathogenesis and surgical treatment of epithelial pilonidal sinus (Review of the literature) // Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2015;(2):69–78. (In Russ.).