Farklı Tekniklerle Tedavi Edilen Pilonidal Sinüs Olgularının Sonuçlarının Karşılaştırılması
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Dosyalar
Tarih
2007
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Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Pilonidal sinüs intergluteal bölgede, özellikle genç erkeklerde daha sık görülen, akut ağrılı veya kronik şekli olan bir hastalıktır. Bu hastalığın tedavisinde çok sayıda cerrahi teknik ve tıbbi metod tanımlanmıştır. Bu prospektif çalışmada kliniğimizde 4 farklı cerrahi tedavi metodu uygulanan pilonidal sinüslü hastaların takip sonuçlarını sunmayı amaçladık. Yöntem: Ocak 2004-Ağustos 2005 yılları arasında Selçuk Üniversitesi Meram Tıp Fakültesi Genel Cerrahi Kliniği’nde pilonidal sinüs nedeniyle değişik tekniklerle opere edilen 92 hasta 15 gün, 1 ay, 3 ay, 6 ay ve 1 yıl sonra kontrole çağırılarak sonuçlar değerlendirildi. 44 (% 48) hastaya eksizyon Limberg flep, 26 (% 28) hastaya eksizyon primer sütür, 14 (% 15) hastaya eksizyon marsüpializasyon, 8 (% 9) hastaya eksizyon Karidakis flep uygulandı. Bulgular: 81 (% 88) hasta ortalama 1 yıl takip edildi. Erken dönemde primer kapama ile tedavi edilen hastalardan 6’sında, Karidakis flep uygulananların 1’inde, Limberg flep ve marsüpiyalizasyon yapılan hastaların ise 2’sinde yüzeyel infeksiyon gelişti. Hastalar antibiyoterapi ve pansuman ile tedavi edildi. 1 ay sonraki yapılan kontrollerinde marsüpiyalizasyon yapılan hastalar hariç diğerlerinin yaralarının tamamen iyileştiği ve hiçbir hastada erken nüks gelişmediği izlendi. 6 ay sonra primer kapama yapılan 3 hastada, marsüpiyalizasyon yapılan 1 hastada nüks tesbit edildi. 1 yıl sonra daha önce nüks tesbit edilen hastalar dışında hiçbir problem olmadığı görüldü. Sonuç: Pilonidal sinüs hastalığının cerrahi tedavisinde erken dönemde yara infeksiyonunun, geç dönemde rekürrensin ve günlük hayata dönme süresinin daha az olması nedeniyle flep kullanılarak yapılan kapama yöntemleri diğer cerrahi girişimlere göre üstün ve etkilidir.
Objective: Pilonidal sinus is a intergluteal region disease and it is especially more common in young men with an acute or chronic pain. There are many medical modalities and surgical techniques in the treatment of disease. At this prospective study we aimed to present four different types of surgical methods and their following results in patient with pilonidal sinus. Methods: 92 patients who were operated different types of surgical techniques on between January 2004 and August 2005 at the General Surgery Departments of Selcuk University, Meram Medical Faculty for pilonidal disease, they were called for control at 15th day, 1st month, 3d month, 6th month and 1st year later and their results were recorded. For 44 (48%) patients we applied excision + Limberg flap (40 hemovac dren used), for 26 patient (28%) we applied excision + primary sutur, 14 (15%) patient excision + marsupialization and for 8 (9%) patient we applied excision + Karydakis flap (6 hemovac dren used). Results: 81 patients were followed for a year. At early stage, in 6 of primary closure patients, 1of Karydakis flap patient and 2 of Limberg flap-marsupialization patients there were superficial infection. All infected patients treated with antibiotics and dressing. After 1 month later control except marsupialization applied patients, all infected patients treated properly and none of them had a recurrence. But we detected recurrence 3 of primary closure patients and 1of marsupialization patient. One year later except patients with recurrence we did not observe any problem. Conclusion: Flap closure methods is better and effective than other surgical treatment techniques because of wound infection control at early stage and less recurrence rate at later stage and early return of daily life in pilonidal sinüs.
Objective: Pilonidal sinus is a intergluteal region disease and it is especially more common in young men with an acute or chronic pain. There are many medical modalities and surgical techniques in the treatment of disease. At this prospective study we aimed to present four different types of surgical methods and their following results in patient with pilonidal sinus. Methods: 92 patients who were operated different types of surgical techniques on between January 2004 and August 2005 at the General Surgery Departments of Selcuk University, Meram Medical Faculty for pilonidal disease, they were called for control at 15th day, 1st month, 3d month, 6th month and 1st year later and their results were recorded. For 44 (48%) patients we applied excision + Limberg flap (40 hemovac dren used), for 26 patient (28%) we applied excision + primary sutur, 14 (15%) patient excision + marsupialization and for 8 (9%) patient we applied excision + Karydakis flap (6 hemovac dren used). Results: 81 patients were followed for a year. At early stage, in 6 of primary closure patients, 1of Karydakis flap patient and 2 of Limberg flap-marsupialization patients there were superficial infection. All infected patients treated with antibiotics and dressing. After 1 month later control except marsupialization applied patients, all infected patients treated properly and none of them had a recurrence. But we detected recurrence 3 of primary closure patients and 1of marsupialization patient. One year later except patients with recurrence we did not observe any problem. Conclusion: Flap closure methods is better and effective than other surgical treatment techniques because of wound infection control at early stage and less recurrence rate at later stage and early return of daily life in pilonidal sinüs.
Açıklama
Anahtar Kelimeler
Pilonidal Sinüs, Cerrahi Tedavi, Komplikasyon, Pilonidal Sinus, Techniques of Surgery, Complication
Kaynak
Genel Tıp Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
17
Sayı
2
Künye
Küçükkartallar, T., Tekin, A., Vatansev, C., Aksoy, F., Erenoğlu, B., (2007). Farklı Tekniklerle Tedavi Edilen Pilonidal Sinüs Olgularının Sonuçlarının Karşılaştırılması. Genel Tıp Dergisi, 17(2), 95-97.
