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Comparison of Three Surgical Techniques in Pilonidal Sinus Surgery
Abdulcabbar Kartal1, Hüseyin Onur Aydın2, Mehmet Oduncu3
1Department of General Surgery, Okan University Medicine Faculty, Istanbul, Turkey. abdulcabbar.kartal@okan.edu.tr.
Prague Medical Report
|February 20, 2019
Summary
Comparing surgical treatments for sacrococcygeal pilonidal sinus disease, the Karydakis flap showed fewer complications, while primary closure offered shorter surgery and hospital stays. Both methods outperformed Limberg transposition flap.
Area of Science:
- Colorectal Surgery
- Surgical Oncology
- Pilonidal Sinus Disease Treatment
Background:
- Pilonidal sinus disease (PSD) is a chronic condition requiring surgical intervention.
- Various surgical techniques exist for PSD, each with distinct outcomes.
- Optimizing surgical outcomes for PSD remains an area of active clinical research.
Purpose of the Study:
- To compare the surgical outcomes of Limberg transposition flap (LTF), Karydakis flap (KF), and primary closure (PC) for sacrococcygeal pilonidal sinus disease.
- To evaluate operative time, hospital stay, early surgical complications, and recurrence rates for each technique.
- To determine the most effective surgical approach for treating pilonidal sinus disease.
Main Methods:
- Retrospective analysis of 634 patients with pilonidal sinus disease treated between January 2014 and January 2016.
- Patients were divided into three groups based on surgical procedure: LTF (131 patients), KF (232 patients), and PC (271 patients).
- Data collected included patient demographics, operative details, postoperative outcomes, complications, and recurrence rates.
Main Results:
- No significant differences in age, sex ratio, or removed sinus volume between groups.
- Primary closure (PC) had the shortest mean operative time (26.9 min) and hospital stay.
- Karydakis flap (KF) demonstrated superior outcomes regarding early surgical complications (p<0.001) and recurrence rates compared to PC (p<0.001).
Conclusions:
- Primary closure is advantageous for reducing surgery duration and hospitalization.
- Karydakis flap excels in minimizing postoperative complications, including seroma, hematoma, wound dissociation, infection, and recurrence.
- Both PC and KF show superiority over LTF in specific outcome measures for pilonidal sinus disease treatment.
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