Long‐term results of endoscopic pilonidal sinus treatment vs Limberg flap for treatment of difficult cases of complicated pilonidal disease: a prospective, nonrandomized study

2019 ◽  
Vol 22 (3) ◽  
pp. 319-324 ◽  
Author(s):  
M. Romaniszyn ◽  
J. S. Swirta ◽  
P. J. Walega
2015 ◽  
Vol 100 (5) ◽  
pp. 870-877 ◽  
Author(s):  
Mehmet Tokac ◽  
Ersin Gurkan Dumlu ◽  
Murat Seyit Aydin ◽  
Abdussamed Yalcın ◽  
Mehmet Kilic

The best surgical technique for pilonidal sinus disease (PSD) is still disputed. The objective of this prospective randomized study is to compare the short and long-term results of modified Limberg flap and Karydakis flap surgeries that have been widely used in recent years. Ninety one patients were included in the study. The patients were divided into two groups: modified Limberg flap (MLF; n = 46) and Karydakis flap (KF; n = 45). Preoperative findings of the patients, their surgical findings, and short and long-term postoperative findings were recorded and statistically compared. While no significant difference was discovered between the groups in terms of postoperative analgesic need, hospital stay, postoperative infection rate, drain stay time, painless sitting time, painless toilet-sitting time, and painless walking time, return to work or school time was shorter in the MLF group compared with the KF group (20.61 ± 7.89 days, 23.29 ± 6.42, respectively; P < 0.05). Cosmetically, the visual analog scale (VAS) of the KF group was significantly higher than that of the MLF group (VAS score 7.12 ± 1.28, 5.45 ± 1.77, respectively; P < 0.05). Considering recurrence rates, no statistically significant difference was found between the groups. Our study found out that short and long-term results of the MLF and KF procedures are similar. We believe both methods can be safely used in surgical PSD treatment given that in the MLF procedure, shorter return-to-work time is achieved, while the procedure provides better cosmetic results.


2014 ◽  
Vol 99 (1) ◽  
pp. 28-34 ◽  
Author(s):  
Fatih Altintoprak ◽  
Kemal Gundogdu ◽  
Tolga Ergonenc ◽  
Enis Dikicier ◽  
Guner Cakmak ◽  
...  

Abstract The aim of this study was to evaluate the results of cases with pilonidal sinus (PS) disease that underwent Limberg flap (LF) transposition and to compare the short and long-term results of early discharge cases with those in the literature. A total of 345 patients who underwent rhomboid excision and LF transposition for PS were evaluated retrospectively. No major anesthetic or surgical complications occurred. Partial wound dehiscence, localized flap necrosis, hematoma, wound infection, and seroma rates were determined as 4.0, 2.1, 1.5, 3.3, and 3.7% respectively. All patients other than those with a hematoma or localized necrosis were discharged with a drain in place 24 hours after the operation. The recurrence rate was 3.9% after a mean 33.1-month follow-up (range, 6–72 months). As a result, we found that short and long-term results of patients who underwent LF and were discharged 24 hours after the operation were similar to those in the literature. We suggest that patients without postoperative complications, such as hematoma or flap necrosis, can be discharged early.


2017 ◽  
Vol 4 (11) ◽  
pp. 3641
Author(s):  
Madhusudhan A. ◽  
Madhan D. P. Swamy ◽  
Mohhamad Arif

Background: The etiology and pathogenesis of sacro-coccygeal pilonidal sinus are not clear. The pathogenesis of the disease is hypothesized to be related to the accumulation of weak and lifeless hair in the intergluteal region, which over time gives rise to foreign body reaction, causing abscess and sinus formation. A deep natal cleft with one of favourable factors enhance sacro-coccygeal pilonidal sinus, e.g., sweating, maceration, bacterial contamination and penetration of hairs. Obesity, trauma, local irritation and a sedentary lifestyle are usually associated with PS. Although pilonidal sinus can be treated using various conservative and surgical methods, recurrence rate remains high. Complete surgical removal of the pilonidal sinus or sinuses and appropriate reconstruction can lead to successful recovery. However, collection of the lifeless hair depends on the anatomy of the intergluteal area, and accompanying risk factors can lead to subsequent recurrence.Methods: The objective of this study is to compare the immediate post-operative and long-term results of Limberg flap and Karydakis flap, which are being widely used now to treat pilonidal sinus disease. It was a retrospective observational study where the patients (total number of patients-30) who underwent both the procedures were compared, Limberg flap (LF; n = 13) and Karydakis flap (KF; n = 17).Results: Present study found out that short and long-term results of the LF and KF procedures are similar. In present study we also noted that all patients with pilonidal sinus disease were men, and most of them had jobs which involved sitting for long durations. Poor hygiene and hirsutism however was not noted in most of the patients, and was not objectively assessed.Conclusions: Both the techniques can be used safely and effectively in sacro coccygeal pilonidal sinus disease.


2003 ◽  
Vol 46 (11) ◽  
pp. 1545-1548 ◽  
Author(s):  
Koray Topgül ◽  
Ersin Özdemir ◽  
Kadir Kiliç ◽  
Hakan Gökbayir ◽  
Zafer Ferahköşe

2008 ◽  
Vol 0 (ja) ◽  
pp. 080504221750330 ◽  
Author(s):  
Murat Akin ◽  
Hakan Gokbayir ◽  
Kadir Kilic ◽  
Koray Topgul ◽  
Ersin Ozdemir ◽  
...  

2010 ◽  
Vol 76 (9) ◽  
pp. 995-999 ◽  
Author(s):  
Khaled M. Madbouly

The purpose of this study was to analyze the long-term outcome of rhomboid excision with Limberg flap reconstruction (LF) as one-day surgery in treatment of recurrent pilonidal sinus (RPS). The effect of obesity on outcome will be addressed. Forty-nine patients with RPS were treated by rhomboid excision and LF as one-day surgery. Data collected included demographics, body mass index, operative time, flap ischemia, wound infection, length of hospital stay, time of complete healing, and recurrence. Patients’ mean age was 33.4 years and mean number of previous operations was 3.4. Operative time ranged from 40 to 70 minutes. Two patients developed sterile seroma (4.1%) and two patients (4.1%) had wound infections. No wound dehiscence or flap ischemia was reported. All patients returned to normal activity within 7 days. No recurrences were reported after a mean follow-up of 32.1 months. Obesity significantly increased the operative time, however, it affected neither the postoperative outcome nor the long-term recurrence. Rhomboid excision and LF as one-day surgery is a safe and reliable method for treatment of RPS. It guarantees low morbidity, short hospital stay, short time off work, and carries low risk of recurrence, even in obese patients.


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