Sinus laser therapy versus Karydakis flap procedure in the management of pilonidal sinus disease: a comparative analysis of intraoperative parameters and postoperative outcome.

IF 2.7 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Techniques in Coloproctology Pub Date : 2024-12-19 DOI:10.1007/s10151-024-03058-3
H Akyol
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Abstract

Background: This study aimed to investigate the utility of minimally invasive sinus laser therapy (SiLaT) versus flap surgery (Karydakis flap procedure) in terms of intraoperative parameters and postoperative outcome in patients with pilonidal sinus disease (PSD).

Methods: A total of 106 patients with PSD (mean ± SD age: 26.4 ± 7.0 years, 86.8% male) treated with Karydakis flap procedure (KF group; n = 63) or sinus laser therapy (SiLaT group; n = 43) were included in this retrospective study. Data on patient demographics, operative characteristics (number of openings, length of sinus tract, and operative time), and postoperative outcome including postoperative (day 1) pain intensity-visual analog scale (VAS) scores, time to return to work after surgery (days), complication rate, and recurrence rate were recorded in each patient and compared between KF and SiLaT groups.

Results: The SiLaT versus KF procedure was associated with significantly shorter operative time [median (min-max) 17 (12-28) versus 27 (20-44) min, p = 0.001], lower pain scores [3 (1-4) versus 5 (3-7), p = 0.001], and earlier return to work [1 (1-3) versus 10 (5-20) days, p = 0.001]. Although no significant difference was noted in complication and recurrence rates between the KF and SiLaT groups, 6.3% (wound infection only) and 3.2% of patients in the KF group but none of the patients in the SiLaT group developed complication and recurrence, respectively.

Conclusions: SiLaT seems to be a promising minimally invasive technique for the management of PSD, being comparable to the KF procedure in terms of complications and recurrence, along with added advantages of shorter operative time, reduced postoperative pain, and earlier return to work.

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鼻窦激光治疗与心核瓣手术治疗毛毛窦疾病:术中参数和术后结果的比较分析。
背景:本研究旨在探讨微创鼻窦激光治疗(SiLaT)与皮瓣手术(Karydakis皮瓣手术)在治疗毛毛窦疾病(PSD)患者的术中参数和术后结果方面的应用。方法:106例PSD患者(平均±SD年龄:26.4±7.0岁,男性86.8%)行Karydakis皮瓣手术治疗(KF组;n = 63)或鼻窦激光治疗(SiLaT组;N = 43)被纳入回顾性研究。记录每位患者的患者人口统计学数据、手术特征(开口数量、窦道长度和手术时间)和术后结果(包括术后(第1天)疼痛强度-视觉模拟量表(VAS)评分、术后恢复工作时间(天)、并发症发生率和复发率),并比较KF组和SiLaT组之间的差异。结果:SiLaT与KF手术显著缩短手术时间[中位(min-max) 17(12-28)对27(20-44)分钟,p = 0.001],疼痛评分较低[3(1-4)对5 (3-7),p = 0.001],更早恢复工作[1(1-3)对10(5-20)天,p = 0.001]。虽然KF组和SiLaT组之间的并发症和复发率没有显著差异,但KF组的患者分别为6.3%(仅伤口感染)和3.2%,而SiLaT组的患者均无并发症和复发率。结论:SiLaT似乎是一种很有前途的治疗PSD的微创技术,在并发症和复发方面与KF手术相当,并且具有更短的手术时间,减少术后疼痛和更早恢复工作的优势。
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来源期刊
Techniques in Coloproctology
Techniques in Coloproctology GASTROENTEROLOGY & HEPATOLOGY-SURGERY
CiteScore
5.30
自引率
9.10%
发文量
176
审稿时长
1 months
期刊介绍: Techniques in Coloproctology is an international journal fully devoted to diagnostic and operative procedures carried out in the management of colorectal diseases. Imaging, clinical physiology, laparoscopy, open abdominal surgery and proctoperineology are the main topics covered by the journal. Reviews, original articles, technical notes and short communications with many detailed illustrations render this publication indispensable for coloproctologists and related specialists. Both surgeons and gastroenterologists are represented on the distinguished Editorial Board, together with pathologists, radiologists and basic scientists from all over the world. The journal is strongly recommended to those who wish to be updated on recent developments in the field, and improve the standards of their work. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1965 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted. Reports of animal experiments must state that the Principles of Laboratory Animal Care (NIH publication no. 86-23 revised 1985) were followed as were applicable national laws (e.g. the current version of the German Law on the Protection of Animals). The Editor-in-Chief reserves the right to reject manuscripts that do not comply with the above-mentioned requirements. Authors will be held responsible for false statements or for failure to fulfill such requirements.
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