Sakrokoksigeal pilonidal sinüs cerrahi tedavisinde limberg flep ile primer kapama tekniğinin karşılaştırılması

Amaç: Bu çalışmada, iki farklı cerrahi tedavi tekniği uygulanan pilonidal sinüslü olguların takip sonuçlarının sunulması amaçlandı. Gereç ve Yöntemler: Bitlis Devlet Hastanesi'nde Ekim 2011 ve Eylül 2014 tarihleri arasında pilonidal sinüs nedeniyle tek cerrah tarafından rhomboid eksizyon + Limberg flep veya eksizyon + primer kapama tekniği uygulanan 123 hasta prospektif olarak değerlendirildi. Grup 1 (n=65) Limberg flep uygulanan olgular, Grup 2 (n=58) ise Primer kapama uygulanan olgulardan oluşmaktaydı. Olgular postoperatif komplikasyon ve nüks açısından değerlendirildi. Bulgular: Hastalarımızın 109'u (%88.6) erkek, 14'ü (%11.4) kadın olup, erkek/kadın oranı 7.8/1 idi. Postoperatif komplikasyon olarak en sık seroma (n=10) ve enfeksiyon (n=9) ile karşılaşıldı. Komplikasyonlar incelendiğinde gruplar arasında anlamlı fark saptandı (p=0.012). Grup 1'de 14.7±4.4 ay, Grup 2'de ise 14.6±4.3 ay olgular nüks yönünden takip edildi. Grup 1'de 1 olguda, Grup 2'de ise 8 olguda nüks tespit edildi. Her iki grupta hastalık nüksü açısından önemli istatistiki fark mevcuttu (p=0.009). Gruplar arasında postoperatif ağrı ve işe dönüş süresi açısından anlamlı fark saptanmadı. Sonuç: Bu çalışmada primer kapama tekniği ile daha fazla enfeksiyon ve nüks oranı saptandı. Postoperatif ağrı ve işe dönüş açısından fark saptanmadı. Son yıllarda giderek popülarite kazanan Limberg flep tekniğinin, gerek düşük enfeksiyon oranı, gerekse kabul edilebilir nüks oranı ile pilonidal sinüs tedavisinde etkin kullanılabileceğine inanıyoruz.

Comparison of limberg flap and primary suture technique in surgical treatment of sacrococcygeal pilonidal sinus

Objective: In this study, we aim to present the results of two different surgical techniques in sacrococcygeal pilonidal sinus that we operated on. Materials and Methods: 123 patients who underwent Limberg flap or primary suture for pilonidal sinus by a single surgeon were evaluated prospectively at Bitlis State Hospital between October 2011 and September 2014. Patients were divided into two groups: in group 1 (n=65), rhomboid excision of tissue was applied and wound was closed with Limberg flap. In group 2 (n=58), after excision, wound was primarily closed. All patients were evaluated for postoperative complication and recurrence. Results: 109 (88.6%) of patients were male and 14 (11.4%) were female, the proportion of male to female patients was 7.8/1. The most common postoperative complications were seroma (n=10) and infection (n=9) in the both groups. Significant difference was detected in both groups for complications (p=0.012). Patients were followed up 14.7±4.4 months in group 1 and 14.6±4.3 months in group 2. Recurrence rate was more common in group 2 (n=8) when compared to group 1 (n=1). A statistically significant difference was determined in both groups for recurrence (p=0.009). There was no differences between groups as far as postoperative pain and time to return work is concerned. Conclusion: Recurrence was noticed more commonly in the patients with primary repair compared to Limberg flap repair in this study. No significant difference in terms of postoperative pain and time to return to work being found. We arrived to the conclusion that Limberg flap is a good technique for the repair of pilonidal sinus disease due to less recurrence rate and infection rate.

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