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Background. Despite a variety of existing methods of surgical treatment for sacrococcygeal pilonidal cyst, a universal technique has not been developed yet, due to the large number of postoperative complications and recurrences.Objectives. To improve the treatment outcomes of patients with pilonidal cysts through developing and implementing a new method for closure of the postoperative wound defect of the sacrococcygeal region.Methods. We conducted a randomized trial, involving 60 patients with sacrococcygeal pilonidal cyst. The control and main groups consisted of 30 people each. The study was carried out in the Purulent Surgery Unit of the Regional Clinical Hospital No. 1 — Research Institute, Krasnodar. The inclusion of patients in the trial was organized within 2019–2022 period. The duration of each patient’s follow-up period was equal to the hospitalization duration. The control group underwent the surgical treatment in the Moszkowicz (Moshkovich) modifi cation. The main group was treated by means of our own developed method. Postoperative wound complications were assessed according to Clavien—Dindo classifi cation. Statistical data processing was performed using Microsoft Excel 2013 with the add-ins Analysis package and AtteStat for statistical data.Results. The control and main groups included 30 participants each. The gender, age and body mass index (BMI) were not defi ned as statistically signifi cant. When analyzing the primary data, the treatment median time accounted for 10.5 (9.0; 13.8) days in the control group and 7.0 (7.0; 8.0) days in the main group, a signifi cant difference according to the Mann—Whitney test (p < 0.001). The number of postoperative complications (suture failure, wound abscess, necrosis of skin fl aps) in the control group was 16 cases, and in the main group — 1 case (signifi cance of differences under the chi-squared test p < 0.001). The number of recurrences in the control group comprised 7 cases, while in the main group there was 1 case (signifi cance of differences under the chi-squared test p = 0.023).Conclusion. The application of surgical treatment for pilonidal cysts in the authors’ modifi cation made it possible to reduce the time of hospitalization, the number of such postoperative complications as suture failure, wound abscess and necrosis of skin fl aps. The number of recurrences has also decreased significantly.
Background. Despite a variety of existing methods of surgical treatment for sacrococcygeal pilonidal cyst, a universal technique has not been developed yet, due to the large number of postoperative complications and recurrences.Objectives. To improve the treatment outcomes of patients with pilonidal cysts through developing and implementing a new method for closure of the postoperative wound defect of the sacrococcygeal region.Methods. We conducted a randomized trial, involving 60 patients with sacrococcygeal pilonidal cyst. The control and main groups consisted of 30 people each. The study was carried out in the Purulent Surgery Unit of the Regional Clinical Hospital No. 1 — Research Institute, Krasnodar. The inclusion of patients in the trial was organized within 2019–2022 period. The duration of each patient’s follow-up period was equal to the hospitalization duration. The control group underwent the surgical treatment in the Moszkowicz (Moshkovich) modifi cation. The main group was treated by means of our own developed method. Postoperative wound complications were assessed according to Clavien—Dindo classifi cation. Statistical data processing was performed using Microsoft Excel 2013 with the add-ins Analysis package and AtteStat for statistical data.Results. The control and main groups included 30 participants each. The gender, age and body mass index (BMI) were not defi ned as statistically signifi cant. When analyzing the primary data, the treatment median time accounted for 10.5 (9.0; 13.8) days in the control group and 7.0 (7.0; 8.0) days in the main group, a signifi cant difference according to the Mann—Whitney test (p < 0.001). The number of postoperative complications (suture failure, wound abscess, necrosis of skin fl aps) in the control group was 16 cases, and in the main group — 1 case (signifi cance of differences under the chi-squared test p < 0.001). The number of recurrences in the control group comprised 7 cases, while in the main group there was 1 case (signifi cance of differences under the chi-squared test p = 0.023).Conclusion. The application of surgical treatment for pilonidal cysts in the authors’ modifi cation made it possible to reduce the time of hospitalization, the number of such postoperative complications as suture failure, wound abscess and necrosis of skin fl aps. The number of recurrences has also decreased significantly.
ЦЕЛЬ ИССЛЕДОВАНИЯ: улучшение результатов хирургического лечения пациентов с пилонидальной кистой. ПАЦИЕНТЫ И МЕТОДЫ: исследование являлось экспериментальным рандомизированным; проведено среди 100 пациентов с ПК в хронической стадии на базе ГБУЗ НИИ-ККБ №1, отделение гнойной хирургии с января 2021 по январь 2023 гг. В основной группе выполнялось иссечение пилонидальной кисты с пластическим закрытием раневого дефекта крестцово-копчиковой области, согласно патенту RU №2751821 от 19.07.21 г. А в контрольной группе выполнялось иссечение ПК с ушиванием по общепризнанному способу по Bascom II (cleft lift). Статистически значимых различий в возрасте (р = 0,355), ИМТ (р = 0,467), распределении по полу (р = 1,0) и частоте рецидивов (р = 0,204) в сравниваемых группах не было. Время операции в основной группе было больше (р < 0,001), что связано с более трудоемкой методикой операции. Койкодень (р = 0,027), частота осложнений (р = 0,028) в основной группе статистически значимо была меньше. РЕЗУЛЬТАТЫ: несмотря на разработанные современные способы хирургического лечения ПК, частота осложнений остается высокой, хотя частоту рецидивов удалось снизить по сравнению с ранее принятыми методами лечения. При применении разработанного и запатентованного нами способа удалось снизить частоту осложнений до 4%, а частоту рецидивов -до 2%, удалось избежать повторных хирургических вмешательств и добиться раннего восстановления трудовой активности. ЗАКЛЮЧЕНИЕ: разработанный нами способ закрытия раневого дефекта после иссечения ПК прост в техническом исполнении и надёжен, что позволяет предложить его в рутинной практике хирургического лечения ПК.
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