مقایسه‌ی نتایج دو روش جراحی باز و نیمه بسته در درمان سینوس پایلونیدال
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حامد فلاح
مهرداد صیادی نیا
مجید صفرپناه
مهرداد صیادی نیا
مجید صفرپناه
چکیده
مقدمه: سینوس پایلونیدال، بیماری التهابی است که به صورت حاد و مزمن در ناحیه‌ی ساکروکوکسیژیال ایجاد می‌شود. پاتوژنز بیماری بطور دقیق مشخص نیست و درمان انتخابی، جراحی می‌باشد؛ که به روش‌های مختلف قابل انجام است. در مطالعه‌ی حاضر نتایج دو روش جراحی باز و نیمه بسته بررسی و مقایسه گردید.
شیوه‌ی مطالعه: تعداد 150 بیمار از میان مبتلایان به سینوس پیلونیدال مراجعه‌کننده به بیمارستان شهید محمدی بندرعباس که کاندید جراحی بودند، بصورت تصادفی به دو گروه مساوی شامل گروه 1 با روش جراحی باز و گروه 2 با روش جراحی نیمه بسته تقسیم شدند. داده‌ها در سطح 0/05 > p value معنی‌دار تلقی شد.
یافته‌ها: نتایج نشان داد، مدت زمان بستری بیمار، بهبودی کامل زخم، دوری از کار و میزان بروز خون‌ریزی در گروه 2 نسبت به گروه 1 بطور معنی‌دار (0/05 > p value) کاهش یافت. از نظر میزان عود و عفونت در دو روش اختلاف معنی‌داری وجود نداشت. همچنین بین عوامل دموگرافیک و میزان بروز عوارض ارتباط معنی‌داری مشاهده نشد.
نتیجه‌گیری: در گروه 2، مدت زمان بستری و بازگشت به فعالیت و میزان خون‌ریزی بعد از عمل نسبت به گروه 1 کمتر بود و میزان رضایت از روش درمانی در گروه 2، به طور معنی‌دار بیشتر بود و با توجه به عدم تفاوت در میزان بروز عوارض در دو گروه نتیجه‌گیری شد که روش جراحی نیمه بسته نسبت به روش باز ارجح است.
کلمات کلیدی: جراحی باز؛ جراحی نیمه بسته؛ سینوس پایلونیدال
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استناد به مقاله
فلاحح., صیادی نیام., & صفرپناهم. (2023). مقایسه‌ی نتایج دو روش جراحی باز و نیمه بسته در درمان سینوس پایلونیدال. مجله دانشکده پزشکی زابل, 19-24. Retrieved از http://jzms.ir/index.php/JZMS/article/view/349
نوع مقاله
مقاله پژوهشی
مراجع
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8. Aydede H, Erhan Y, Sakarya A, Kumkumoglu Y. Comparison of three methods in surgical treatment of pilonidal disease. ANZ J Surg 2001; 71(6): 362-4.
9. da Silva JH. Pilonidal cyst: cause and treatment. Dis Colon Rectum 2000; 43(8): 1146-56.
10. Keshava A, Young CJ, Rickard MJF, Sinclair G. Karydakis flap repair for sacrococcygeal pilonidal sinus disease: how important is technique? ANZ J Surg 2007; 77(3): 181-3.
11. McCallum IJ, King PM, Bruce J. Healing by primary closure versus open healing after surgery for pilonidal sinus: systematic review and meta-analysis. BMJ 2008; 336(7649): 868-71.
12. Karydakis GE. Easy and successful treatment of pilonidal sinus after explanation of its causative process. Aust N Z J Surg 1992; 62(5): 385-9.
13. Karahan Ö, Sevinç B, Şimşek G, Demirgül R. Minimally invasive treatment of pilonidal sinus disease using platelet-rich plasma. Translational Surgery 2016; 1(1): 14.
14. Doll D, Evers T, Matevossian E, Petersen S. Outcome of chronic pilonidal disease treatment after ambulatory plain midline excision and primary suture. Am J Surg 2009; 197(5): 693-4.
15. Sakr MF, Elserafy ME, Hamed HM, Ramadan MA, Kantoush HE, El-Torky HM. Management of 634 consecutive patients with chronic pilonidal sinus: a nine-year experience of a single institute. Surgical Science 2012; 3(3);
18043.
16. Lasheen A, Safwat K, Morsy M, Fiad A, Elmoregy A. Excision and partial primary closure of wound for pilonidal disease. Surgical Science 2012; 3(7): 366-70.
17. Haji Barati B, Ghafuri A. Surgical management of pilonidal sinus patients by primary and secondary repair methods: a comparative study [in Persian]. Tehran Univ Med J 2010; 68(9): 553-8.
18. Ghafouri A, Haji Barati B, Mahmoodzadeh H, Khorgami Z. The comparison of the results of pilonidal sinus surgery with primary closure versus open method [in Persian]. IJS 2011; 18(4).
19. ElGohary H. Semi-closed method as alternative to open and closed methods for the treatment of pilonidal sinus disease. Ain Shams J Surg 2017; 10(2): 188-92.
20. McGuinness JG, Winter DC, O’Connell PR. Vacuum-assisted closure of a complex pilonidal sinus. Dis Colon Rectum 2003; 46(2): 274-6.
21. Mehrvarz S, Mohebbi HA, Manoochehry S, Arjmand S, Rasouli HR. Comparison of outcomes in four different surgical methods for sacral pilonidal sinus with long-term follows-up [in Persian]. Tehran Univ Med J 2019; 76(10): 660-4.
22. Mohebbi HA, Abolghasemi H, Towliat Kashani SM, Fanaii SA, Kabir A. The efficacy of horse collagen (Antema) in hemostasis of bleeding due to dental procedures, pilonidal sinus surgery, hemorrhoidectomy and laminectomy [in Persian]. Sci J Iran Blood Transfus Organ 2006; 3(3): 243-51.
23. Tocchi A, Mazzoni G, Bononi M, Fornasari V, Miccini M, Drumo A, et al. Outcome of chronicpilonidal disease treatment after ambulatory plain midline excision and primary suture. Am J Surg 2008; 196(1): 28-33.
24. Peyvandi H, Mirhashemi SH, Moghaddam K, Hadizadeh NGM, Ahmadi H, Mafi AA. Comparison of pilonidal sinus surgeryusing primary repair with advanced flap and secondary improvement [in Persian]. JIMC 2016; 34(2): 119-24.
25. Hemati HR, Ghorbani R, Nayeri Tarshizi E. Recurrence rate in the pilonidal sinus after excision with or without primary closure [in Persian]. Koomesh 2013; 15(1): 78-82.
2. Dalenbäck J, Magnusson O, Wedel N, Rimbäck G. Prospective follow-up after ambulatory plain midline excision of pilonidal sinus and primary suture under local anaesthesia--efficient, sufficient, and persistent. Colorectal Dis 2004; 6(6): 488-93.
3. Dalenback J. Prospective follow-up after ambulatory plain midline excision of pilonidal sinusand primary suture under local anaesthesia-efficient, sufficient, and persistent. Colorectal Dis 2006; 8(1): 73-4.
4. Lund J. Tou S, Doleman B, Williams JP. Fibringlue versus surgery for treating chronic pilonidal sinus disease. The Cochrane Library; 2015.
5. Buie LA. Classic articles in colonic and rectal surgery. Louis A. Buie, M.D. 1890-1975: Jeep disease (pilonidal disease of mechanized warfare). Dis Colon Rectum 1982; 25(4): 384-90.
6. Akinci OF, Coskun A, Uzunköy A. Simpleand effective surgical treatment of pilonidal sinus. Dis Colon Rectum 2000; 43(5): 701-6.
7. Kement M, Oncel M, Kurt N, Kaptanoglu L. Sinus excision for the treatment of limited chronic pilonidal disease: results after a medium-term follow-up. Dis Colon Rectum 2006; 49(11): 1758-62.
8. Aydede H, Erhan Y, Sakarya A, Kumkumoglu Y. Comparison of three methods in surgical treatment of pilonidal disease. ANZ J Surg 2001; 71(6): 362-4.
9. da Silva JH. Pilonidal cyst: cause and treatment. Dis Colon Rectum 2000; 43(8): 1146-56.
10. Keshava A, Young CJ, Rickard MJF, Sinclair G. Karydakis flap repair for sacrococcygeal pilonidal sinus disease: how important is technique? ANZ J Surg 2007; 77(3): 181-3.
11. McCallum IJ, King PM, Bruce J. Healing by primary closure versus open healing after surgery for pilonidal sinus: systematic review and meta-analysis. BMJ 2008; 336(7649): 868-71.
12. Karydakis GE. Easy and successful treatment of pilonidal sinus after explanation of its causative process. Aust N Z J Surg 1992; 62(5): 385-9.
13. Karahan Ö, Sevinç B, Şimşek G, Demirgül R. Minimally invasive treatment of pilonidal sinus disease using platelet-rich plasma. Translational Surgery 2016; 1(1): 14.
14. Doll D, Evers T, Matevossian E, Petersen S. Outcome of chronic pilonidal disease treatment after ambulatory plain midline excision and primary suture. Am J Surg 2009; 197(5): 693-4.
15. Sakr MF, Elserafy ME, Hamed HM, Ramadan MA, Kantoush HE, El-Torky HM. Management of 634 consecutive patients with chronic pilonidal sinus: a nine-year experience of a single institute. Surgical Science 2012; 3(3);
18043.
16. Lasheen A, Safwat K, Morsy M, Fiad A, Elmoregy A. Excision and partial primary closure of wound for pilonidal disease. Surgical Science 2012; 3(7): 366-70.
17. Haji Barati B, Ghafuri A. Surgical management of pilonidal sinus patients by primary and secondary repair methods: a comparative study [in Persian]. Tehran Univ Med J 2010; 68(9): 553-8.
18. Ghafouri A, Haji Barati B, Mahmoodzadeh H, Khorgami Z. The comparison of the results of pilonidal sinus surgery with primary closure versus open method [in Persian]. IJS 2011; 18(4).
19. ElGohary H. Semi-closed method as alternative to open and closed methods for the treatment of pilonidal sinus disease. Ain Shams J Surg 2017; 10(2): 188-92.
20. McGuinness JG, Winter DC, O’Connell PR. Vacuum-assisted closure of a complex pilonidal sinus. Dis Colon Rectum 2003; 46(2): 274-6.
21. Mehrvarz S, Mohebbi HA, Manoochehry S, Arjmand S, Rasouli HR. Comparison of outcomes in four different surgical methods for sacral pilonidal sinus with long-term follows-up [in Persian]. Tehran Univ Med J 2019; 76(10): 660-4.
22. Mohebbi HA, Abolghasemi H, Towliat Kashani SM, Fanaii SA, Kabir A. The efficacy of horse collagen (Antema) in hemostasis of bleeding due to dental procedures, pilonidal sinus surgery, hemorrhoidectomy and laminectomy [in Persian]. Sci J Iran Blood Transfus Organ 2006; 3(3): 243-51.
23. Tocchi A, Mazzoni G, Bononi M, Fornasari V, Miccini M, Drumo A, et al. Outcome of chronicpilonidal disease treatment after ambulatory plain midline excision and primary suture. Am J Surg 2008; 196(1): 28-33.
24. Peyvandi H, Mirhashemi SH, Moghaddam K, Hadizadeh NGM, Ahmadi H, Mafi AA. Comparison of pilonidal sinus surgeryusing primary repair with advanced flap and secondary improvement [in Persian]. JIMC 2016; 34(2): 119-24.
25. Hemati HR, Ghorbani R, Nayeri Tarshizi E. Recurrence rate in the pilonidal sinus after excision with or without primary closure [in Persian]. Koomesh 2013; 15(1): 78-82.