美国结直肠外科医师协会(The American Society of Colon and Rectal Surgeons,ASCRS)于2019年2月公布了最新的藏毛窦诊治临床实践指南。指南是由国际知名结直肠外科专家组成的临床实践指南委员会修订,对藏毛窦的一些争议进行了汇总和...美国结直肠外科医师协会(The American Society of Colon and Rectal Surgeons,ASCRS)于2019年2月公布了最新的藏毛窦诊治临床实践指南。指南是由国际知名结直肠外科专家组成的临床实践指南委员会修订,对藏毛窦的一些争议进行了汇总和分析。展开更多
Pilonidal sinus disease has led to heated debates since it was first described in the medical literature. Although a consensus has been built on its etiology and pathogenesis, the same course has not progressed for tr...Pilonidal sinus disease has led to heated debates since it was first described in the medical literature. Although a consensus has been built on its etiology and pathogenesis, the same course has not progressed for treatment modality. This review is a short article about the process of pilonidal sinus disease from past to present. Some important points were mentioned between the years 1833, which is accepted as the milestone for the awareness of the disease, in which it was first reported until the year of 1880, in which it was given its name. Although its name has been the same for about two centuries, some other names such as "Jeep Disease" have also been used depending on the population affected by the disease. At present, it is indisputable that the disease is acquired. Large series were presented about the treatment in the last two decades. Some surgical methods were even named after the ones who first described them and they have many supporters. However, since the treatment modalities have some advantages and disadvantages and they do not have marked superiority over others, debates still continue. We hope that pilonidal sinus disease will not lose its significance and be underrated in parallel with the developments in technology and specialization in medicine.展开更多
AIM: To review the current data about the success rates of fibrin sealant use in pilonidal disease.METHODS: Fibrin sealant can be used for different purposes in pilonidal sinus treatment, such as filling in the sinus ...AIM: To review the current data about the success rates of fibrin sealant use in pilonidal disease.METHODS: Fibrin sealant can be used for different purposes in pilonidal sinus treatment, such as filling in the sinus tracts, covering the open wound after excision and lay-open treatment, or obliterating the subcutaneous dead space before skin closure. We searched Pubmed, Google-Scholar, Ebsco-Host, clinicaltrials, and Cochrane databases and found nine studies eligible for analysis; these studies included a total of 217 patients(84% male, mean age 24.2 ± 7.8). RESULTS: In cases where fibrin sealant was used to obliterate the subcutaneous dead space, there was no reduction in wound complication rates(9.8% vs 14.6%, P = 0.48). In cases where sealant was used to cover the laid-open area, the wound healing time and patient comfort were reported better than in previous studies(mean 17 d, 88% satisfaction). When fibrin sealant was used to fill the sinus tracts, the recurrence rate was around 20%, despite the highly selected grouping of patients.CONCLUSION: Consequently, using fibrin sealant to decrease the risk of seroma formation was determined to be an ineffective course of action. It was not advisable to fill the sinus tracts with fibrin sealant because it was not superior to other cost-effective and minimally invasive treatments. New comparative studies can be conducted to confirm the results of sealant use in covering the laid-open area.展开更多
Background: Pilonidal disease is a common chronic disorder of the sacrococcygeal region;and its surgical management is still a matter of discussion. The ideal therapy would be a quick cure that allowed patients to ret...Background: Pilonidal disease is a common chronic disorder of the sacrococcygeal region;and its surgical management is still a matter of discussion. The ideal therapy would be a quick cure that allowed patients to return rapidly to normal activity, that is minimally invasive with no morbidity, a low risk of complication and easy to learn. Methods: Sixty seven patients with pilonidal disease were subjected to excision and partial closure procedure, from November 2006 to March 2010 at General Surgery Department, Zagazig University Hospital, Zagazig University, Egypt. The mean age was 27.5 years. Complete but close excision of all diseased tissues was achieved. Then, the wound partially was closed from the deepest parts only by multiples buried vertical mattress sutures by using Lasheen’s needle, and left the superficial wound parts to heal by second intention. The follow up period was ranged from 14 - 39 months (mean 27 months). Results: The mean hospital stay was 12 hours, mean operation time was 30 minutes and mean time to return to normal activity was 8 days (range 7 - 12 days). Nine cases show superficial wound infection and one case of recurrence. Conclusion: Excision and partially closure technique by using Lasheen’s needle for pilonidal diseases is minimal invasive and less morbidity, easy to learn and has favorable results regarding to return to normal activity, rate of recurrence and cosmetically acceptable.展开更多
<b><span style="font-family:Verdana;">Background</span></b><span style="font-family:Verdana;"><strong></strong></span><strong><b><span...<b><span style="font-family:Verdana;">Background</span></b><span style="font-family:Verdana;"><strong></strong></span><strong><b><span style="font-family:Verdana;">:</span></b><span style="font-family:Verdana;"></span></strong><span style="font-family:Verdana;"> Pilonidal disease is a chronic inflammatory disease of the sacrococcygeal region that mainly affects young people. Its incidence is 26 cases per 100,000 persons. Although many techniques have been described, there is no consensus on the treatment of pilonidal sinus disease (PSD). </span><span style="font-family:Verdana;"><strong></strong></span><strong><b><span style="font-family:Verdana;">Materials</span></b><span style="font-family:Verdana;"></span></strong><b><span style="font-family:;" "=""> </span></b><span style="font-family:Verdana;"><strong></strong></span><strong><b><span style="font-family:Verdana;">and</span></b><span style="font-family:Verdana;"></span></strong><span style="font-family:;" "=""> </span><span style="font-family:Verdana;"><strong></strong></span><strong><b><span style="font-family:Verdana;">Methods</span></b><span style="font-family:Verdana;"></span></strong><strong><b><span style="font-family:Verdana;">:</span></b><span style="font-family:Verdana;"></span></strong><b><span style="font-family:;" "=""> </span></b><span style="font-family:Verdana;">This study included 30 patients with PSD who were treated between May 2014 and September 2017. All cases underwent excision and flap reconstruction. The operative time, postoperative complications, the length of hospital stay, painless sitting and walking time, patient satisfaction and recurrence were evaluated prospectively. </span><span style="font-family:Verdana;"><strong></strong></span><strong><b><span style="font-family:Verdana;">Results</span></b><span style="font-family:Verdana;"></span></strong><strong><b><span style="font-family:Verdana;">:</span></b><span style="font-family:Verdana;"></span></strong><b><span style="font-family:;" "=""> </span></b><span style="font-family:Verda展开更多
文摘Pilonidal sinus disease has led to heated debates since it was first described in the medical literature. Although a consensus has been built on its etiology and pathogenesis, the same course has not progressed for treatment modality. This review is a short article about the process of pilonidal sinus disease from past to present. Some important points were mentioned between the years 1833, which is accepted as the milestone for the awareness of the disease, in which it was first reported until the year of 1880, in which it was given its name. Although its name has been the same for about two centuries, some other names such as "Jeep Disease" have also been used depending on the population affected by the disease. At present, it is indisputable that the disease is acquired. Large series were presented about the treatment in the last two decades. Some surgical methods were even named after the ones who first described them and they have many supporters. However, since the treatment modalities have some advantages and disadvantages and they do not have marked superiority over others, debates still continue. We hope that pilonidal sinus disease will not lose its significance and be underrated in parallel with the developments in technology and specialization in medicine.
文摘AIM: To review the current data about the success rates of fibrin sealant use in pilonidal disease.METHODS: Fibrin sealant can be used for different purposes in pilonidal sinus treatment, such as filling in the sinus tracts, covering the open wound after excision and lay-open treatment, or obliterating the subcutaneous dead space before skin closure. We searched Pubmed, Google-Scholar, Ebsco-Host, clinicaltrials, and Cochrane databases and found nine studies eligible for analysis; these studies included a total of 217 patients(84% male, mean age 24.2 ± 7.8). RESULTS: In cases where fibrin sealant was used to obliterate the subcutaneous dead space, there was no reduction in wound complication rates(9.8% vs 14.6%, P = 0.48). In cases where sealant was used to cover the laid-open area, the wound healing time and patient comfort were reported better than in previous studies(mean 17 d, 88% satisfaction). When fibrin sealant was used to fill the sinus tracts, the recurrence rate was around 20%, despite the highly selected grouping of patients.CONCLUSION: Consequently, using fibrin sealant to decrease the risk of seroma formation was determined to be an ineffective course of action. It was not advisable to fill the sinus tracts with fibrin sealant because it was not superior to other cost-effective and minimally invasive treatments. New comparative studies can be conducted to confirm the results of sealant use in covering the laid-open area.
文摘Background: Pilonidal disease is a common chronic disorder of the sacrococcygeal region;and its surgical management is still a matter of discussion. The ideal therapy would be a quick cure that allowed patients to return rapidly to normal activity, that is minimally invasive with no morbidity, a low risk of complication and easy to learn. Methods: Sixty seven patients with pilonidal disease were subjected to excision and partial closure procedure, from November 2006 to March 2010 at General Surgery Department, Zagazig University Hospital, Zagazig University, Egypt. The mean age was 27.5 years. Complete but close excision of all diseased tissues was achieved. Then, the wound partially was closed from the deepest parts only by multiples buried vertical mattress sutures by using Lasheen’s needle, and left the superficial wound parts to heal by second intention. The follow up period was ranged from 14 - 39 months (mean 27 months). Results: The mean hospital stay was 12 hours, mean operation time was 30 minutes and mean time to return to normal activity was 8 days (range 7 - 12 days). Nine cases show superficial wound infection and one case of recurrence. Conclusion: Excision and partially closure technique by using Lasheen’s needle for pilonidal diseases is minimal invasive and less morbidity, easy to learn and has favorable results regarding to return to normal activity, rate of recurrence and cosmetically acceptable.
文摘<b><span style="font-family:Verdana;">Background</span></b><span style="font-family:Verdana;"><strong></strong></span><strong><b><span style="font-family:Verdana;">:</span></b><span style="font-family:Verdana;"></span></strong><span style="font-family:Verdana;"> Pilonidal disease is a chronic inflammatory disease of the sacrococcygeal region that mainly affects young people. Its incidence is 26 cases per 100,000 persons. Although many techniques have been described, there is no consensus on the treatment of pilonidal sinus disease (PSD). </span><span style="font-family:Verdana;"><strong></strong></span><strong><b><span style="font-family:Verdana;">Materials</span></b><span style="font-family:Verdana;"></span></strong><b><span style="font-family:;" "=""> </span></b><span style="font-family:Verdana;"><strong></strong></span><strong><b><span style="font-family:Verdana;">and</span></b><span style="font-family:Verdana;"></span></strong><span style="font-family:;" "=""> </span><span style="font-family:Verdana;"><strong></strong></span><strong><b><span style="font-family:Verdana;">Methods</span></b><span style="font-family:Verdana;"></span></strong><strong><b><span style="font-family:Verdana;">:</span></b><span style="font-family:Verdana;"></span></strong><b><span style="font-family:;" "=""> </span></b><span style="font-family:Verdana;">This study included 30 patients with PSD who were treated between May 2014 and September 2017. All cases underwent excision and flap reconstruction. The operative time, postoperative complications, the length of hospital stay, painless sitting and walking time, patient satisfaction and recurrence were evaluated prospectively. </span><span style="font-family:Verdana;"><strong></strong></span><strong><b><span style="font-family:Verdana;">Results</span></b><span style="font-family:Verdana;"></span></strong><strong><b><span style="font-family:Verdana;">:</span></b><span style="font-family:Verdana;"></span></strong><b><span style="font-family:;" "=""> </span></b><span style="font-family:Verda
