Sakrokoksigeal Pilonidal Sinüsün Cerrahi Tedavisi

Pilonidal Sinüs hastalığı, özellikle genç erkek erişkinler gibi üreten nüfusta ve sakrokoksigeal bölgede gözlenir. Tedavisinin nasıl olacağı konusunda tam bir fikir birliği sağlanmamış olması, kronik tekrarlama ihtimalinin yüksek olması, tıbbi bakımının uzun ve ekonomik olarak da yüklü sürmesi gibi nedenlerden ötürü oldukça ilgi gören bir hastalıktır. Tekrarlama ihtimali oldukça yüksek olması ve üreten çalışan nüfusta da fazla gözlenmesi konu ile ilgili çok sayıda çalışma yapılmasına yol açmıştır. Bu yazıda sakrokoksigeal pilonidal sinus hastalığının asıl tedavisi olan cerrahi tedavi yöntemleri kısaca gözden geçirilmiştir.

Anahtar Kelimeler:

Pilonidal sinus, sakrokoksigeal, flep, rezeksiyon

Surgical Treatment of Sacrococcygeal Pilonidal Disease

Pilonidal disease is usually observed in the sacrococcygeal region of young male adults. Because of the absence of a consensus on the treatment of the disease, high recurrence rates, high direct and indirect cost and need for a long wound care, it is a highly reputable disease. High incidence rates in the working population along with high recurrence rates led the surgeons to focus on the treatment of the disease intensely. In this article, the surgical treatment option for sacrococcygeal pilonidal disease has been briefly reviewed.

Keywords:

Pilonidal sinus, sacrococcygeal, flap, resection.,

PDF

___

Da Silva JH. Pilonidalcyst: cause and treatment. Dis Colon Rectum. 2000; 43:1146–56. Papaconstantinou HT, Thomas JS. Pilonidal disease and hidradenitissuppurativa. In The ASCRS Textbook of Colon and Rectal Surgery: 2nd ed. (E David, L PatriciaL, RT Saclarides, J Anthony, JS Michael, DS Steven): 261-9. New York, Springer, 2011
Bascom J. Pilonidal disease: origin from follicles of hairs and results of follicle removal as treatment. Surgery. 1980; 87:567-72.
Lord PH, Millar DM. Pilonidal sinus a simple treatment. Br J Surg. 1965; 52:299-300.
Senapati A, Cripps NP, Thompson MR. Bascom's operation in the day-surgical management of symptomatic pilonidal sinus. Br J Surg. 2000; 87:1067-70.
Gencosmanoglu R, Inceoglu R. Modiﬁed lay-open (incision, curettage, partial lateral wall excision and marsupialization) versus total excision with primary closure in the treatment of chronic sacrococcygeal pilonidal sinus. Int J Colorectal Disease. 2005; 20:415-22.
Fazeli MS, Adel MG, Abaschi AH. Comparison of outcomes in Z-plasty and delayed healing by secondary intention of the wound after excision of the sacral pilonidal sinus: results of a randomized, clinical trial. Dis Colon Rectum. 2006; 49:1831-6.
Jamal A, Shamim, M, Hashim F, Quershi M. Open excision with secondary healing versus rhomboid excision with Limberg transposition ﬂap in the management of Sacrococcygeal Disease. J Pakistan Med Assoc. 2009; 59:157-60.
Füzün M, Bakir H, Soylu M, Tansu, T, Kamak E, Harmancioglu O. Which technique for treatment of pilonidal sinus--open or closed?. Dis Colon Rectum. 1994; 37:1148-50.
Kareem T. Surgical treatment of chronic sacrococcygeal pilonidal sinus Open method versus primary closure. Saudi Med J. 2006; 27:1534-7.
Sİndenaa K, Nesvik I, Andersen E, Sİreide JA. Recurrent pilonidal sinus after excision with closed or open treatment: ﬁnal result of a randomised trial. Eur J Surg. 1996; 162:237-40.
Al-Khamis A, McCallum I, King PM, Bruce J. Healing by primary versus secondary intention after surgical treatment for pilonidal sinus. Cochrane Database Syst Rev. 2010; 1:CD006213. Gencosmanoglu R, Inceoglu R. Modiﬁed lay-open (Incision, Curettage, Partial lateral wall excision and Marsupialization) versus Total Excision with Primary Closure in the treatment of chronic sacrococcygeal pilonidal sinus. Intl J Colorectal Disease 2005; 20:415-22.
Kronborg O, Christensen K, Zimmermann-Nielsen C. Chronic pilonidal disease: a randomized trial with a complete 3-year follow-up. Br J Surg. 1985; 72:303-4. al-Hassan HK, Francis IM, Neglén P. Primary closure or secondary granulation after excision of pilonidal sinus? Acta Chirurgica Scandinavica. 1990; 156:695-9.