Unroofing Curettage Versus Modified Limberg Flap in Pilonidal Disease: A Retrospective Cohort Study
Diseases of the Colon and Rectum, cilt.65, sa.10, ss.1241-1250, 2022 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 65 Sayı: 10
- Basım Tarihi: 2022
- Doi Numarası: 10.1097/dcr.0000000000002227
- Dergi Adı: Diseases of the Colon and Rectum
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, PASCAL, CAB Abstracts, EMBASE, MEDLINE
- Sayfa Sayıları: ss.1241-1250
- Anahtar Kelimeler: Healing time, Modified Limberg flap, Pilonidal disease, Quality of life, Recurrence, Unroofing curettage
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
BACKGROUND: Sacrococcygeal pilonidal disease (estimated incidence, 25/100,000) is a chronic inflammatory condition that commonly affects young adults. However, the ideal surgical treatment for this disease remains undetermined. OBJECTIVE: This study aimed to compare the results of the unroofing curettage and those of the modified Limberg flap surgical technique. DESIGN: This is a retrospective cohort study. SETTINGS: Procedures were performed by 2 surgeons between January 2013 and January 2017. PATIENTS: The data of 278 patients who underwent surgery for the treatment of pilonidal disease were analyzed. INTERVENTIONS: Unroofing curettage was performed under local or spinal anesthesia, whereas spinal anesthesia was used for the modified Limberg flap procedure. MAIN OUTCOME MEASURES: The primary outcome was recurrence rate. Secondary outcomes included adverse events, limitation of daily activities, and healing time. RESULTS: Between the 2 groups (unroofing curettage, n = 135; modified Limberg flap, n = 143), recurrence was lower in the unroofing curettage group after a 60-month median follow-up period, but the difference was not statistically significant (1.5% vs 4.2%, p = 0.45). The duration of surgery and length of hospital stay were shorter in the unroofing curettage group (11.44 ± 3.56 minutes vs 52.47 ± 7.92 minutes and 0.27 ± 0.45 days vs 1.07 ± 0.26 days, p < 0.001). Postoperative complications were significantly higher in the modified Limberg flap group (9.8% vs 2.2%, p = 0.009). The time required to return to work or school was shorter in the unroofing curettage group (8.6 ± 7.8 days vs 25.01 ± 6.3 days, p < 0.001). The complete healing time was longer in the unroofing curettage group (35.3 ± 9.2 days vs 23.2 ± 5.4 days, p < 0.001). LIMITATIONS: The retrospective study design was a limitation of this study. CONCLUSIONs: Unroofing curettage provided more clinical benefits than the modified Limberg flap approach. Unroofing curettage should be considered as the first choice of surgical treatment for pilonidal disease. See Video Abstract at http://links.lww.com/DCR/B824.