Pilonidal sinus hastalığında Rhomboid eksizyon ve Modifiye Limberg flep uygulanan hastalarda tek merkez klinik deneyiminin değerlendirilmesi

Abstract

Amaç: Pilonidal sinüs hastalığı (PSD), özellikle genç erkeklerde görülen, sıklıkla sakrokoksigeal bölgede yerleşim gösteren ve kişinin yaşam kalitesini ve günlük hayatını olumsuz etkileyen bir kronik inflamatuvar hastalıktır. Bu çalışmada; PSD’de elektif olarak Rhomboid eksizyon ve Modifiye Limberg flep uygulanan hasta grubunda klinik yaklaşımımızı ve sonuçlarımızı inceleyerek deneyimimizi literatürle paylaşmayı amaçladık. Gereç ve Yöntem: Genel cerrahi kliniğinde PSD nedeniyle elektif olarak rhomboid eksizyon ve modifiye limberg flep uygulaması yapılan hastalar çalışmaya dahil edildi. Hastalara ait demografik ve klinik parametreler retrospektif olarak araştırıldı. Bulgular: Çalışmaya dahil edilen 76 hastanın yaş ortalaması 27,5 ± 8,5 yıl idi (18-51 yaş). Hastaların median hastanede yatış süresi 2 gün idi. Cerrahide en sık tercih edilen profilaktik antibiyotik sefuroksim+ metranidazol (%60,5) kombinasyonu veya sadece sefuroksim (%32,9) idi. Olguların yaklaşık %40’ında dren kullanımı mevcuttu. Cilt altı dokular olguların çoğunda (%94,7) tek kat poliglaktin sütur ile kapatılmıştı. Median 12 aylık takip süresi içerisinde, postoperatif sadece 6 olguda (%7,9) nüks izlenmişti. Sonuç: Consequently, Rhomboid eksizyon + Modifiye Limberg flep tekniği iyi tanımlanmış, safe and feasible bir cerrahi metoddur. Etkin bir off-midline teknik olması sebebiyle elektif PSD cerrahisinde komplike, unkomplike ve rekürren vakalarda deneyimli cerrahlar tarafından uygulanması, junior ve resident cerrahlara aktarılması midline tekniklerden uzaklaşılması açısından etkin olacaktır.

Keywords

• Pilonidal sinüs hastalığı
• rhomboid eksizyon
• limberg flep
• pilonidal sinüs eksizyonu

Evaluation of single center clinical experience in patients undergoing modified Limberg flap technique in pilonidal sinus disease

Abstract

Aims: Pilonidal sinus disease (PSD) is a chronic inflammatory disease that is seen especially in young men, is often located in the sacrococcygeal region and negatively affects the quality of life and daily life of the person. In this study, we aimed to share our experience with the literature by examining our clinical approach and results in the patient group who underwent Modified Limberg flap technique electively in PSD. Methods: Patients who underwent elective modified Limberg flap application due to PSD in the general surgery clinic were included in the study. Demographic and clinical parameters of the patients were investigated retrospectively. Results: The mean age of 76 patients included in the study was 27.5±8.5 years (18-51 years). The median duration of hospitalisation was 2 days. The most commonly preferred prophylactic antibiotic at surgery was cefuroxime + metranidazole combination (60.5%) or cefuroxime alone (32.9%). Drain use was present in approximately 40% of the cases. Subcutaneous tissues were closed with a single layer of polyglactin suture in most cases (94.7%). During the median follow-up period of 12 months, postoperative recurrence was observed in only 6 cases (7.9%). Conclusions: Modified Limberg flap technique is a well-defined, safe and feasible surgical method. Since it is an effective off-midline technique, its application by experienced surgeons in complicated and recurrent cases in elective PSD surgery and its transfer to junior and resident surgeons will be effective in terms of moving away from midline techniques.

Keywords

• Pilonidal sinus disease
• modified Limberg flap
• pilonidal sinus excision

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