三种皮瓣技术治疗骶尾部藏毛窦的临床疗效观察

Effectiveness of three flap reconstruction techniques for treatment of sacrococcy⁃geal pilonidal sinus

目的分析Limberg皮瓣技术、Karydakis皮瓣技术和BascomⅡ皮瓣技术治疗骶尾部藏毛窦的临床疗效。方法纳入2007年8月至2022年1月在南京中医药大学附属医院肛肠科接受Limberg皮瓣技术、Karydakis皮瓣技术或BascomⅡ皮瓣技术治疗的60例非急性炎症期骶尾部藏毛窦患者为研究对象,按照手术方式的不同进行分组,各组患者例数分别为29例、9例、22例。记录手术相关指标(手术时间、术后并发症)及术后随访情况。结果Limberg皮瓣技术组、Karydakis皮瓣技术组、BascomⅡ皮瓣技术组的平均手术时间分别为(82.4±21.2)min、(61.7±28.2)min、(77.4±26.2)min,术后出现切口相关并发症的患者分别为7例(24.1%)、2例、5例(22.7%)。Limberg皮瓣技术组中位随访时间为90.7(68.3,108.0)个月,随访期内1例(3.4%)患者于术后10个月复发。Karydakis皮瓣技术组平均随访时间为(52.7±4.2)个月,随访期内1例患者于术后半年复发。BascomⅡ皮瓣技术组中位随访时间为8.5(7.7,17.3)个月,随访期内2例(9.1%)患者于术后半年复发。结论对于非急性炎症期骶尾部藏毛窦,Limberg皮瓣技术、Karydakis皮瓣技术或BascomⅡ皮瓣技术均是较为理想的治疗术式。

Objectives To investigate the effectiveness of three flap reconstruction techniques(Limberg flap,Karydakis flap,and BascomⅡprocedure)for treating sacrococcygeal pilonidal sinus.Methods Sixty patients with non-acute-inflammatoryphase sacrococcygeal pilonidal sinus treated with three flap reconstruction techniques(Limberg flap,Karydakis flap,BascomⅡprocedure)at the Department of Anorectal Diseases,Affiliated Hospital of Nanjing University of Chinese Medicine,between Au⁃gust 2007 and January 2022 were recruited.Depending on the surgical technique,patients were divided into three groups:Lim⁃berg flap group(n=29),Karydakis flap group(n=9),and BascomⅡprocedure group(n=22).Duration of surgery,postoperative complications,and postoperative follow-ups were recorded.Results The mean(SD)duration of surgery for the Limberg flap group,Karydakis flap group,and BascomⅡprocedure group were 82.4(21.2)min,61.7(28.2)min,and 77.4(26.2)min,respective⁃ly.The number of patients experiencing incision-related postoperative complications were 7(24.1%),2,and 5(22.7%),respectively.For the Limberg flap group,the median follow-up was 90.7(68.3,108.0)months,and one(3.4%)patient had recurrence at 10 months after surgery.For the Karydakis flap group,the mean(SD)follow-up was 52.7(4.2)months,one patient had recurrence at 6 months after surgery.For the BascomⅡprocedure group,the median follow-up was 8.5(7.7,17.3)months,two(9.1%)patients had recurrence at 6 months after surgery.Conclusion For patients with non-acute-inflammatory-phase sacrococcygeal pilonidal sinus,all of the Limberg flap,Karydakis flap,and BascomⅡprocedure are treatment options with satisfactory effectiveness.