Fenolizasyon ve SILaC Lazer: Pilonidal Sinüs Hastalığının Tedavisinde Hangisi Daha Başarılı?

Amaç: Bu çalışmada pilonidal sinüs hastalığının (PSD) tedavisinde fenol uygulaması ile sinüs lazer yardımıyla kapatma (SiLaC) yöntemlerini karşılaştırmayı amaçladık. Gereç ve Yöntemler: Fenol grubunda 73, lazer grubunda 68 hasta olmak üzere toplam 141 hasta iki gruba ayrıldı. Hastaların demografik özellikleri, sigara içme durumu, komorbidite varlığı, apse drenajı öyküsü, geçirilmiş PSD cerrahisi, nüks durumu, tekrar ameliyat ihtiyacı, postoperatif komplikasyonlar, orifisin orta hattan uzaklığı ve sinüs trakt sayısı retrospektif olarak kaydedildi ve gruplar arasında karşılaştırıldı. Bulgular: Demografik özellikler ve hastalıksız sağkalım (DFS) açısından iki grup arasında istatistiksel olarak anlamlı bir fark gözlenmedi. Daha önce pilonidal sinüs cerrahisi geçirmiş hastalarda, sigara içen hastalarda ve komplikasyon gelişen hastalarda DFS istatistiksel olarak anlamlı derecede daha kısa idi. Her iki grup arasında nüks oranı benzerdi. Daha önce geçirilmiş pilonidal sinüs cerrahisi, sigara kullanımı ve komplikasyonlar ,hastalıksız sağkalımı etkileyen faktörler olarak saptandı. Sinüs traktlarının sayısı ve orifisin orta hatta olan mesafesi nüksü etkileyen faktörlerdi. ROC eğrisi analizine göre orifis mesafesi >1.4 cm için cut-off değeri rekürens gelişimini %100 duyarlılık ve %92.91 özgüllük ile öngörmüştür. Sonuç: Bu çalışmanın sonuçları, nispeten daha yeni olan SILaC yöntemi ile fenolizasyon tekniği arasında nüks ve başarı oranlarının benzer olduğunu göstermektedir. Komplikasyon oranları da benzerdir. PSD tedavisinde her iki yöntem de güvenli ve etkin bir şekilde kullanılabilir.

Anahtar Kelimeler:

Pilonidal sinüs hastalığı, orifis, sinüs yolu, fenol, lazer, SILaC

Phenolization vs SILaC Laser: Which is More Successful in the Treatment of Pilonidal Sinus Disease?

Objective: In this study we aimed to compare phenol application and sinus laser-assisted closure (SiLaC) methods for the treatment of pilonidal sinus disease (PSD). Materials and Methods: A total of 141 patients were divided into two groups with 73 patients being in the phenol group and 68 patients in the laser group. Patients’ demographic characteristics, smoking status, presence of co-morbidities, history of abscess drainage, previous PSD surgery, recurrence status, need for re-operation, postoperative complications, distance of orifice from the midline and number of sinus tract were retrospectively recorded and compared between the groups. Results: No statistically significant difference was observed between the two groups in terms of demographic features and disease free survival (DFS). DFS was statistically significantly shorter in the patients with previous pilonidal sinus surgery, in smoker patients and in the patients with complications. Recurrence rate was similar between both groups. Previous pilonidal sinus surgery, smoking and complications are the factors affecting disease free survival. Number of sinus tracts and distance of the orifice to the midline are the factors affecting recurrence. According to the ROC curve analysis, a cut-off value for orifice distance >1.4 cm predicted the development of recurrence sensitivity 100%, specificity 92.91%. Conclusion: The results of this study indicate that recurrence and success rates are similar between the relatively newer SILaC method and phenolization technique. Rate of complications is also similar. Both treatment methods can be safely and effectively used for the treatment of PSD.

Keywords:

Pilonidal sinus disease, orifice, sinus tract, phenol, laser, SILaC,

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