激光辅助封闭(SiLaC)手术治疗乳头状窦疾病的结果:成功的相关因素

Murat Yildirim, Bulent Koca
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引用次数: 0

摘要

背景:近年来,采用鼻窦激光辅助闭合术(SiLaC)治疗蝶窦的研究数量有限,但取得了良好的效果。我们的目的是在一家三级医疗培训医院研究这种方法的有效性和安全性,揭示影响失败的因素,并分享我们的初步经验:研究纳入了 2020 年 3 月至 2023 年 12 月间接受该手术治疗的所有成人患者。比较了患者的人口统计学和临床数据、并发症和复发率。对痊愈和未痊愈的患者进行单变量分析,以找出影响成功治疗的因素。利用单变量分析中的重要因素进行逻辑回归分析:研究队列由 64 名患者组成。平均随访时间为(17.0±8.06)个月(范围:3 至 36),平均恢复工作时间为(2.4±2.78)天(范围:0 至 14)天。康复率为 85.9%。并发症发生率为 14%,大部分(50%)为伤口感染。在治疗成功和治疗失败患者的对比中,高体重指数和晚期疾病是导致复发的重要因素(P0.05):SiLaC手术作为一种安全有效、并发症轻微、复发率合理的方法,可能是治疗朝天鼻窦疾病的首选。肥胖患者和晚期患者的成功率有所下降。
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Results of Laser-assisted Closure (SiLaC) Surgery in Pilonidal Sinus Disease: Factors Associated With Success.

Background: Pilonidal sinus treatment with sinus laser-assisted closure (SiLaC) method has produced promising results in a limited number of studies conducted in recent years. We aimed to examine the efficacy and safety of this method in a tertiary care training hospital to reveal the factors affecting failure and to share our first experiences.

Methods: All adult patients treated with this procedure between March 2020 and December 2023 were included in the study. Demographic and clinical data, complications, and recurrence rates of the patients were compared. Univariate analysis was performed between recovered and non-recovered patients to find the factors influencing successful treatment. Logistic regression analysis was performed using significant factors in the single variable analysis.

Results: The study cohort consisted of 64 patients. The mean follow-up period was 17.0±8.06 months (range: 3 to 36), and the mean time for return to work was 2.4±2.78 days (range: 0 to 14). Our recovery rate was 85.9%. The complication rate was 14%, and the majority (50%) were wound infections. High BMI and advanced disease were significant factors for recurrence in the comparison of patients with successful and unsuccessful treatment ( P <0.01 and 0.013, respectively). The same situation persisted in multivariate analysis ( P =0.026, 95% CI: 1.36-7.81, and P =0.004, 95% CI: 1.36-1.78, respectively). In the ROC Curve analysis for BMI, the cutoff point was 29 (sensitivity: 66.9%, specificity: 77.4%, AUC 0.809). Other parameters were not significant ( P >0.05).

Conclusions: The SiLaC procedure may be the treatment of choice for pilonidal sinus disease as a safe and effective method with mild complications and reasonable recurrence rates. The success rate decreased in obese patients and patients with advanced disease.

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来源期刊
CiteScore
2.00
自引率
10.00%
发文量
103
审稿时长
3-8 weeks
期刊介绍: Surgical Laparoscopy Endoscopy & Percutaneous Techniques is a primary source for peer-reviewed, original articles on the newest techniques and applications in operative laparoscopy and endoscopy. Its Editorial Board includes many of the surgeons who pioneered the use of these revolutionary techniques. The journal provides complete, timely, accurate, practical coverage of laparoscopic and endoscopic techniques and procedures; current clinical and basic science research; preoperative and postoperative patient management; complications in laparoscopic and endoscopic surgery; and new developments in instrumentation and technology.
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